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Sleep apnea and cardiovascular disease

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https://www.readbyqxmd.com/read/28220556/association-between-central-sleep-apnea-and-left-ventricular-structure-the-multi-ethnic-study-of-atherosclerosis
#1
Sogol Javaheri, Ravi K Sharma, David A Bluemke, Susan Redline
We assessed whether the presence of central sleep apnea is associated with adverse left ventricular structural changes. We analysed 1412 participants from the Multi-Ethnic Study of Atherosclerosis who underwent both overnight polysomnography and cardiac magnetic resonance imaging. Subjects had been recruited 10 years earlier when free of cardiovascular disease. Our main exposure is the presence of central sleep apnea as defined by central apnea-hypopnea index = 5 or the presence of Cheyne-Stokes breathing...
February 21, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28219664/effect-of-pioglitazone-on-cardiometabolic-risk-in-patients-with-obstructive-sleep-apnea
#2
Alice Liu, Fahim Abbasi, Sun H Kim, Danit Ariel, Cindy Lamendola, James Cardell, Shiming Xu, Shailja Patel, Vanessa Tomasso, Hafasa Mojaddidi, Kaylene Grove, Philip S Tsao, Clete A Kushida, Gerald M Reaven
Prevalence of insulin resistance is increased in patients with obstructive sleep apnea (OSA). Because insulin resistance is an independent predictor of cardiovascular disease (CVD), this study was initiated to see if pioglitazone administration would improve insulin sensitivity and thereby decrease risk of CVD in overweight/obese, nondiabetic, insulin-resistant patients with untreated OSA. Patients (n = 30) were administered pioglitazone (45 mg/day) for 8 weeks, and measurements were made before and after intervention of insulin action (insulin-mediated glucose uptake by the insulin suppression test), C-reactive protein, lipid/lipoprotein profile, and gene expression profile of periumbilical subcutaneous fat tissue...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28217508/obstructive-sleep-apnea-in-type-2-diabetes-and-impact-of-continuous-positive-airway-pressure-therapy-on-glycemic-control
#3
Javid Ahmad Malik, Shariq Rashid Masoodi, Sheikh Shoib
BACKGROUND: Obstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) are two interacting epidemics both with high prevalence and morbidity. Both epidemiologic and clinical studies suggest that the majority of patients with T2DM also have OSA and untreated OSA in these patients results in poor glycemic control leading to acceleration of diabetes-related complications. OBJECTIVES: To assess the prevalence and severity of OSA in T2DM patients and to assess the impact of OSA treatment on presenting symptoms and hemoglobin A1c (HbA1c)...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28215237/severity-of-nocturnal-hypoxia-and-daytime-hypercapnia-predicts-cpap-failure-in-patients-with-copd-and-obstructive-sleep-apnea-overlap-syndrome
#4
Zuzana Kuklisova, Ruzena Tkacova, Pavol Joppa, Emiel Wouters, Manuel Sastry
BACKGROUND: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are independent risk factors for cardiovascular diseases. In patients with OSA and concurrent COPD, continuous positive airway pressure (CPAP) therapy improves survival. Nevertheless, a significant proportion of such patients do not tolerate CPAP. The aim of the present study was to analyze early predictors of CPAP failure in patients with OSA and concurrent COPD, and to evaluate the effects of bilevel positive airway pressure (BiPAP) in this high-risk group of patients...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28209226/sleep-apnea-types-mechanisms-and-clinical-cardiovascular-consequences
#5
REVIEW
Shahrokh Javaheri, Ferran Barbe, Francisco Campos-Rodriguez, Jerome A Dempsey, Rami Khayat, Sogol Javaheri, Atul Malhotra, Miguel A Martinez-Garcia, Reena Mehra, Allan I Pack, Vsevolod Y Polotsky, Susan Redline, Virend K Somers
Sleep apnea is highly prevalent in patients with cardiovascular disease. These disordered breathing events are associated with a profile of perturbations that include intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, all of which are critical mediators of cardiovascular disease. Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Several discoveries in the pathogenesis, along with developments in the treatment of sleep apnea, have accumulated in recent years...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28207497/concurrent-presence-of-inflammation-and-obstructive-sleep-apnea-exacerbates-the-risk-of-metabolic-syndrome-a-koges-6-year-follow-up-study
#6
Jinkwan Kim, Dae Wui Yoon, Seung Ku Lee, Seunggwan Lee, Kyung-Mee Choi, Thomas J Robert, Chol Shin
Obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Both OSA and inflammation play key roles in increased risk of cardiovascular disease (CVD). Thus, we hypothesized that the combination of inflammation and OSA could accelerate the development of metabolic syndrome (MetS) in a large cohort study.A total of 1835 participants were randomly selected from the ongoing Korean Genome and Epidemiology Study for the years between 2007 and 2015...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28197892/the-effect-of-acute-aerobic-exercise-on-hemostasis-in-obstructive-sleep-apnea
#7
Ryan A Martin, Courtney Strosnider, Gabrielle Giersch, Christopher J Womack, Trent A Hargens
PURPOSE: Individuals with obstructive sleep apnea (OSA) have an altered hemostatic balance; however, the exercise response is less described. The purpose of this study is to determine the hemostatic response after acute aerobic exercise in obstructive sleep apnea. METHODS: Eighteen males (nine OSA vs. nine controls) were recruited from the university and local community. Individuals with evidence of cardiovascular, pulmonary, or metabolic disease were excluded. An apnea-hypopnea index (AHI) of >5 was a criterion for OSA...
February 14, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28178304/atrial-fibrillation-among-patients-under-investigation-for-suspected-obstructive-sleep-apnea
#8
Tijn Hendrikx, Martin Sundqvist, Herbert Sandström, Carin Sahlin, Morteza Rohani, Faris Al-Khalili, Rolf Hörnsten, Anders Blomberg, Per Wester, Mårten Rosenqvist, Karl A Franklin
STUDY OBJECTIVES: Obstructive sleep apnea is common among patients with atrial fibrillation, but the prevalence and risk factors for atrial fibrillation among patients who are being investigated on suspicion of sleep apnea are not well known. The aim of the study was to estimate the prevalence of atrial fibrillation among patients investigated for suspected obstructive sleep apnea and to identify risk factors for atrial fibrillation among them. METHODS: The prevalence of atrial fibrillation was investigated among 201 patients referred for suspected obstructive sleep apnea...
2017: PloS One
https://www.readbyqxmd.com/read/28169105/current-evidence-on-prevalence-and-clinical-outcomes-of-co-morbid-obstructive-sleep-apnea-and-chronic-obstructive-pulmonary-disease-a-systematic-review
#9
REVIEW
Md Shajedur R Shawon, Jennifer L Perret, Chamara V Senaratna, Caroline Lodge, Garun S Hamilton, Shyamali C Dharmage
The objective of this systematic review is to synthesize the evidence on prevalence, polysomnographic findings and clinical outcomes of co-morbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) - known as the "overlap syndrome". We systematically searched PubMed on 1 December 2015 using appropriate medical subject headings (MeSH) and text words to capture prevalence studies and comparative studies of any observational design examining the clinical outcomes in patients with co-existent COPD and OSA...
April 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28159091/the-benefits-of-perioperative-screening-for-sleep-apnea-in-surgical-patients
#10
REVIEW
Yamini Subramani, Jean Wong, Mahesh Nagappa, Frances Chung
Obstructive sleep apnea (OSA) is a chronic disease affecting millions of people worldwide. Untreated OSA can lead to about a 2-fold increase in medical expenses, mainly because of cardiovascular morbidity. OSA is highly prevalent in the surgical population, with an increased risk of perioperative complications. This article describes the perioperative and long-term social and economic benefits of preoperative screening for OSA. Screening patients to identify high-risk OSA is important to decrease the adverse outcomes and associated health care costs in the perioperative period...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159089/sleep-health-and-society
#11
REVIEW
Michael A Grandner
Biological needs for sleep are met by engaging in behaviors that are largely influenced by the environment, social norms and demands, and societal influences and pressures. Insufficient sleep duration and sleep disorders such as insomnia and sleep apnea are highly prevalent in the US population. This article outlines some of these downstream factors, including cardiovascular and metabolic disease risk, neurocognitive dysfunction, and mortality, as well as societal factors such as age, sex, race/ethnicity, and socioeconomics...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#12
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
February 2, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28155102/stratification-of-cardiovascular-risk-in-patients-with-atrial-fibrillation-and-obstructive-sleep-apnea-validity-of-the-2mace-score
#13
Anna E Platek, Filip M Szymanski, Krzysztof J Filipiak, Alicja Dudzik-Plocica, Bartosz Krzowski, Grzegorz Karpinski
BACKGROUND: Risk stratification in patients with atrial fibrillation (AF) is critically important because this group is at high risk of mortality and morbidity. One of the comorbidities potentially affecting thromboembolic and total cardiovascular risk is obstructive sleep apnea (OSA). The aim of this study was to determine whether or not patients with atrial fibrillation and concomitant obstructive sleep apnea have a higher predicted cardiovascular risk than those without sleep-disordered breathing...
February 2, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28153627/hematological-evaluation-in-males-with-obstructive-sleep-apnea-before-and-after-positive-airway-pressure
#14
A Feliciano, R Linhas, R Marçôa, A Cysneiros, C Martinho, R P Reis, D Penque, P Pinto, C Bárbara
Obstructive sleep apnea syndrome (OSAS) is a systemic inflammatory disease associated with cardiovascular consequences. Red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) are recognized biomarkers of cardiovascular morbidity/mortality. Limited data is available on the association between these parameters and OSAS severity and the relationship with positive airway pressure therapy (PAP). In this prospective study of male OSAS patients we analyzed hematological data in order to evaluate their value in predicting OSAS severity, the relationship with sleep parameters, and their behavior under PAP...
January 30, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28146212/impact-of-high-risk-for-obstructive-sleep-apnea-on-survival-after-acute-coronary-syndrome-insights-from-the-erico-registry
#15
Flavia C Maia, Alessandra C Goulart, Luciano F Drager, Henrique L Staniak, Itamar de Souza Santos, Paulo Andrade Lotufo, Isabela M Bensenor
BACKGROUND: Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. OBJECTIVE: To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate...
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28144275/serum-of-obstructive-sleep-apnea-patients-impairs-human-coronary-endothelial-cell-migration
#16
Michał Hoffmann, Jacek Wolf, Anna Szyndler, Prachi Singh, Virend K Somers, Krzysztof Narkiewicz
INTRODUCTION: Endothelial cell migration and proliferation play an important role in the growth and development of new blood vessels and endothelium healing. This process occurs in response to injury, inflammation and immune reactions. Dysfunction of the endothelium may play a significant role in development and progression of cardiovascular disease related to sleep-disordered breathing. The aim of our study was to evaluate the chemo-attractant activity of serum from obstructive sleep apnea (OSA) and normal subjects on coronary artery endothelial cell migration...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28143688/sleep-apnea-state-of-the-art
#17
REVIEW
Martin R Cowie
Many patient with, or at risk of, cardiovascular disease have sleep disordered breathing (SDB), which can be either obstructive (with intermittent collapse of the upper airway) or central (episodic loss of respiratory drive). SDB is associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in SDB have either been neutral (obstructive sleep apnea) or suggested the possibility of harm, likely from increased sudden death, in central sleep apnea...
December 20, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28130342/nfat-regulation-of-cystathionine-gamma-lyase-expression-in-endothelial-cells-is-impaired-in-rats-exposed-to-intermittent-hypoxia
#18
Laura V Gonzalez Bosc, Jessica M Osmond, Wieslawa Giermakowska, Carolyn E Pace, Jennifer L Riggs, Olan Jackson-Weaver, Nancy L Kanagy
Sleep apnea is a risk factor for cardiovascular disease, and intermittent hypoxia (IH, 20 episodes/hr of 5% O2/5% CO2 for 7 hr/day) to mimic sleep apnea increases blood pressure and impairs H2S-induced vasodilation in rats. The enzyme that produces H2S, cystathionine gamma lyase (CSE), is decreased in rat mesenteric artery endothelial cells (EC) following in vivo IH exposure. In silico analysis identified putative NFAT binding sites in the CSE promoter. Therefore, we hypothesized that IH exposure reduces [Ca(2+)] activation of calcineurin/NFAT to lower CSE expression and impairs vasodilation...
January 27, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28128967/impact-of-mandibular-advancement-therapy-on-endothelial-function-in-severe-obstructive-sleep-apnea
#19
Frédéric Gagnadoux, Jean-Louis Pépin, Bruno Vielle, Vanessa Bironneau, Frédérique Chouet-Girard, Sandrine Launois, Nicole Meslier, Jean-Claude Meurice, Xuan-Lan Nguyen, Audrey Paris, Pascaline Priou, Renaud Tamisier, Wojciech Trzepizur, François Goupil, Bernard Fleury
RATIONALE: Endothelial dysfunction, a major predictor of late cardiovascular events, is linked to the severity of obstructive sleep apnea (OSA). OBJECTIVES: To determine whether treatment with mandibular advancement device, the main alternative to continuous positive airway pressure, improves endothelial function in patients with severe OSA. METHODS: In this trial, we randomized patients with severe OSA and no overt cardiovascular disease to receive 2 months of treatment with either effective mandibular advancement device or a sham device...
January 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28126505/-obstructive-sleep-apnea-syndrome-diagnostic-strategies-in-various-clinical-settings
#20
Marie Netchitaïlo, Marie Destors, Cécile Bosc, Jean-Louis Pépin, Renaud Tamisier
Obstructive Sleep Apnea Syndrome (OSAS) is a common disease, whose prevalence and expression may vary depending on the associated pathology, age or gender. Thus, the prevalence of OSAS is up to 80% in case of refractory hypertension. This led up to individualize clinical presentation of clusters, although currently, the individualization of these different phenotypes did not conduct to a specific care or predict different evolution. Offering the best strategy for the right patient remains an important objective...
January 23, 2017: La Presse Médicale
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