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https://www.readbyqxmd.com/read/29450504/association-of-adenotonsillectomy-with-blood-pressure-among-hypertensive-and-nonhypertensive-children-with-obstructive-sleep-apnea
#1
Cho-Hsueh Lee, Kun-Tai Kang, Shuenn-Nan Chiu, I-Sheng Chang, Wen-Chin Weng, Pei-Lin Lee, Wei-Chung Hsu
Importance: Hypertension in childhood may continue into adulthood and lead to adverse cardiovascular outcomes. Evidence suggests that adenotonsillectomy for childhood obstructive sleep apnea (OSA) may be associated with blood pressure (BP) improvement. However, how adenotonsillectomy is associated with BP in hypertensive and nonhypertensive children with OSA remains unclear. Objective: To investigate disparities in BP changes after adenotonsillectomy in hypertensive and nonhypertensive children with OSA...
February 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29445096/chronic-intermittent-hypoxia-promotes-myocardial-ischemia-related-ventricular-arrhythmias-and-sudden-cardiac-death
#2
Jessica Morand, Claire Arnaud, Jean-Louis Pepin, Diane Godin-Ribuot
We investigated the effects of intermittent hypoxia (IH), such as that encountered in severe obstructive sleep apnea (OSA) patients, on the development and severity of myocardial ischemia-related ventricular arrhythmias. Rats were exposed to 14 days of IH (30 s at 5%O 2 and 30 s at 21%O 2 , 8 h·day -1 ) or normoxia (N, similar air-air cycles) and submitted to a 30-min coronary ligature. Arterial blood pressure (BP) and ECG were recorded for power spectral analysis, ECG interval measurement and arrhythmia quantification...
February 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#3
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29441807/alterations-of-igf-1-complement-c3-and-superoxide-dismutase-in-patients-with-moderate-to-severe-obstructive-sleep-apnea-hypopnea-syndrome
#4
Xiao Wang, Yufeng Wang, Zechuan Cai, Xiaoxia Lu, Zhenxing Li, Yun Chen, Guoliang Zu, Taoping Li
AIM: To evaluate various biomarkers of metabolism, immunity and inflammation in obstructive sleep apnea hypopnea syndrome (OSAHS). MATERIALS & METHODS: After overnight polysomnography, blood was collected from 292 OSAHS patients or healthy volunteers. Serum content of inflammatory, immune, metabolic biomarkers were investigated. In addition, the effects of 1-month continuous positive airway pressure (CPAP) were studied in moderate/severe OSAHS. RESULTS: C3, serum total complement activity, superoxide dismutase, uric acid were significantly higher in moderate/severe OSAHS than that in no/mild OSAHS...
February 14, 2018: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#5
REVIEW
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29425579/the-impact-of-sleep-disordered-breathing-on-cardiovascular-health-in-overweight-children
#6
Rosemary S C Horne, Genevieve Shandler, Knarik Tamanyan, Aidan Weichard, Alexsandria Odoi, Sarah N Biggs, Margot J Davey, Gillian M Nixon, Lisa M Walter
BACKGROUND: Up to 50% of overweight/obese children have obstructive sleep apnea (OSA) compared to up to 6% of normal weight children. We compared cardiovascular variables between normal weight and overweight/obese children with and without OSA, and controls. METHODS: Seventy-four referred children and 24 normal weight non-snoring controls (8-18 years) were recruited. Referred children were grouped according to their obstructive apnea hypopnea index (OAHI): OSA (>1 event/h) or primary snoring (PS ≤ 1 event/h) and whether they were normal weight (BMI z-score <1...
January 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#7
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29407894/low-sleep-quality-is-associated-with-progression-of-arterial-stiffness-in-patients-with-cardiovascular-risk-factors-hscaa-study
#8
Manabu Kadoya, Masafumi Kurajoh, Miki Kakutani-Hatayama, Akiko Morimoto, Akio Miyoshi, Kae Kosaka-Hamamoto, Takuhito Shoji, Yuji Moriwaki, Masaaki Inaba, Hidenori Koyama
BACKGROUND AND AIMS: Improvement in sleep quality is considered to be a viable target for prevention and treatment of cardiovascular diseases. To gain insight into its underlying mechanisms, we evaluated the significance of objectively measured sleep quality in patients with regard to progression of arterial stiffness over a 3-year follow-up period. METHODS: This prospective cohort study included 306 serial patients registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) study...
January 31, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29388357/airway-obstruction-produces-widespread-sympathoexcitation-role-of-hypoxia-carotid-chemoreceptors-and-nts-neurotransmission
#9
Caroline B Ferreira, Sergio L Cravo, Sean D Stocker
Obstructive sleep apnea (OSA) is the most common respiratory disturbance of sleep and is closely associated to cardiovascular diseases. In humans, apnea increases respiratory effort and elevates muscle sympathetic nerve activity (SNA), but the primary stimulus for the SNA activation has not been identified. We recently developed a model of apnea in rodents using acute airway obstruction. In this study, we employed this model to test whether the elevation in SNA was mediated by hypoxia, carotid chemoreceptors, or neurotransmission in the nucleus tractus solitarius (NTS)...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29386229/the-comprehensive-impact-on-human-body-induced-by-resolution-of-growth-hormone-excess
#10
Zhaoyun Zhang, Qin Li, Wenqiang He, Huijia Qiu, Hongying Ye, Yongfei Wang, Ming Shen, Min He, Yifei Yu, Xuefei Shou, Chuanxin Huang, Huan Yu, Guoqian Huang, Weijun Tang, Daoying Geng, Chaowei Fu, Congjin Liu, Zengyi Ma, Zhao Ye, Qilin Zhang, Yichao Zhang, Yue Shen, Yeping Yang, Meng Wang, Xingdang Liu, Yun Lu, Hu R Ming, Ying Mao, Liangfu Zhou, Yi-Ming Li, Shiqi Li, Nicholas A Tritos, Yao Zhao
CONTEXT: Chronic excess of growth hormone (GH) often leads to systemic complications. The reversibility of these complications after GH resolution is not fully understood. OBJECTIVE: To investigate when and to what extent will the comorbidities be ameliorated. DESIGN: We conducted a prospective study comprising 24 patients with acromegaly, who achieved remission after transsphenoidal surgery. The dynamic changes of endocrine, cardiovascular, respiratory, sleep, bone and morphology parameters were evaluated at enrollment and 1 week, 1 month, 3 months, 6 months and 12 months after surgery...
January 31, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29375933/impact-of-sleep-duration-and-weekend-oversleep-on-body-weight-and-blood-pressure-in-adolescents
#11
Stuart F Quan, Daniel Combs, Sairam Parthasarathy
Introduction: Weekend oversleep or catchup sleep is a frequent occurrence in children, but there are relatively little data concerning its impact on weight and blood pressure. The aim of this study was to assess the association between sleep duration and oversleep, and weight and blood pressure in adolescents. Methods: Sleep duration, weight and blood pressure of 327 children (51.4% boys, mean age 13.3 ± 1.7 years) who had polysomnograms performed during both exam cycles of the Tucson Children's Assessment of Sleep Apnea study (TuCASA) were analyzed...
2018: Southwest Journal of Pulmonary & Critical Care
https://www.readbyqxmd.com/read/29373256/severe-obstructive-sleep-apnea-in-children-with-elevated-blood-pressure
#12
Jane Hinkle, Heidi V Connolly, Heather R Adams, Marc B Lande
The objective was to determine the prevalence of habitual snoring and obstructive sleep apnea (OSA) in a cohort of children referred for elevated blood pressure (BP), and to determine the association between OSA and BP elevation, learning difficulties, and behavioral problems. We performed a retrospective review of 446 consecutive new patients referred for elevated BP. One hundred four (23%) had habitual snoring. Patients with habitual snoring were more likely to be obese (86.5 vs. 55.6%, P < .001) and to have Medicaid insurance (52...
January 3, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29371201/nonmuscle-myosin-light-chain-kinase-a-key-player-in-intermittent-hypoxia-induced-vascular-alterations
#13
Claire Arnaud, Sophie Bouyon, Sylvain Recoquillon, Sandrine Brasseur, Emeline Lemarié, Anne Briançon-Marjollet, Brigitte Gonthier, Marta Toral, Gilles Faury, M Carmen Martinez, Ramaroson Andriantsitohaina, Jean-Louis Pepin
BACKGROUND: Obstructive sleep apnea is characterized by repetitive pharyngeal collapses during sleep, leading to intermittent hypoxia (IH), the main contributor of obstructive sleep apnea-related cardiovascular morbidity. In patients and rodents with obstructive sleep apnea exposed to IH, vascular inflammation and remodeling, endothelial dysfunction, and circulating inflammatory markers are linked with IH severity. The nonmuscle myosin light chain kinase (nmMLCK) isoform contributes to vascular inflammation and oxidative stress in different cardiovascular and inflammatory diseases...
January 25, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29368965/consensus-statement-by-the-american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-on-the-comprehensive-type-2-diabetes-management-algorithm-2018-executive-summary
#14
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACEI = angiotensin-converting enzyme inhibitor; ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BCR-QR = bromocriptine quick release; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardiovascular disease; DASH = Dietary Approaches to Stop Hypertension; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density lipoprotein cholesterol; IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial; LDL-C = low-density lipoprotein cholesterol; LDL-P = low-density lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium glucose cotransporter-2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione; VADT = Veterans Affairs Diabetes Trial...
January 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29363362/sleep-disordered-breathing-in-pregnant-women-maternal-and-fetal-risk-treatment-considerations-and-future-perspectives
#15
Kimberly Truong, Christian Guilleminault
Numerous physiologic and anatomic changes during pregnancy exacerbate or unmask obstructive sleep apnea in women. Left untreated, upper airway flow limitation during pregnancy may lead to dire maternal and fetal health consequences. Areas covered: This review outlines the relationship between sleep disordered breathing (SDB) and gestational hypertension, preeclampsia, and gestational diabetes. It also discusses the implications of SDB on fetal and maternal health and concludes with a review of the emerging literature of treatment options for SDB in pregnancy and its benefit...
January 24, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29362967/does-severe-obstructive-sleep-apnea-syndrome-alter-retrobulbar-blood-flow-a-color-doppler-ultrasound-study
#16
Bülent Çekiç, Ömer Tarık Selçuk, İclal Erdem Toslak, Üstün Osma, Hülya Eyigör, Muhammed Kazım Erol
PURPOSE: To evaluate extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of severe obstructive sleep apnea (OSA) on retrobulbar blood flow. METHODS: Between February 2014 and September 2015, 30 patients with severe OSA (apnea-hypopnea index (AHI) > 30) and 28 controls were prospectively included in this study. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels...
January 23, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29359806/the-role-of-hypoxia-inducible-factors-in-carotid-body-patho-physiology
#17
Gregg L Semenza, Nanduri R Prabhakar
Hypoxia-inducible factors mediate adaptive responses to reduced O2 availability. In patients with obstructive sleep apnea, repeated episodes of hypoxemia and reoxygenation (intermittent hypoxia) are sensed by the carotid body (CB). The ensuing CB chemosensory reflex activates the sympathetic nervous system and increased secretion of catecholamines by the adrenal medulla, resulting in hypertension and breathing abnormalities. In the CB, intermittent hypoxia induces the formation of reactive oxygen species (ROS) and increased intracellular Ca2+ levels, which drive increased expression of hypoxia-inducible factor 1α (HIF-1α) and a decrease in the levels of HIF-2α...
January 23, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29357521/intermittent-hypoxia-in-utero-damages-postnatal-growth-and-cardiovascular-function-in-rats
#18
Ling Chen, Zahra Heidari Zadi, Jin Zhang, Steven M Scharf, Eung-Kwon Pae
PURPOSE: Obstructive sleep apnea (OSA) is common in pregnancy, and may compromise fetal and even postnatal development. We developed an animal model to determine if maternal OSA could have lasting effects in offspring. METHODS: Pregnant Sprague Dawley rats were exposed to reduced ambient O2 from 21 to 4-5 %, approximately once/minute (chronic intermittent hypoxia - CIH) for 8 hours/day during gestation days 3-19. Similarly-handled animals exposed to ambient air served as controls (HC)...
December 14, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29340495/validation-of-the-stop-bang-questionnaire-as-a-means-of-screening-for-obstructive-sleep-apnea-in-adults-in-brazil
#19
Ricardo Luiz de Menezes Duarte, Lorena Barbosa de Moraes Fonseca, Flavio José Magalhães-da-Silveira, Erika Aparecida da Silveira, Marcelo Fouad Rabahi
OBJECTIVE: To validate the Portuguese-language version of the STOP-Bang (acronym for Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) questionnaire, culturally adapted for use in Brazil, as a means of screening for obstructive sleep apnea (OSA) in adults. METHODS: In this validation study, we enrolled patients ≥ 18 years of age, recruited between May of 2015 and November of 2016. All patients completed the STOP-Bang questionnaire and underwent overnight polysomnography...
November 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29338120/the-association-between-different-features-of-sleep-disordered-breathing-and-blood-pressure-a-cross-sectional-study
#20
Shayan Khoshkish, Mathias Hohl, Benedikt Linz, Michael Arzt, Felix Mahfoud, Mathias Baumert, Jakob Schöpe, Michael Böhm, Dominik Linz
Sleep disordered breathing (SDB) is highly prevalent in patients with high blood pressure (BP). Severity of SDB can be evaluated by the number of apneas and hypopneas per hour (AHI) or by measures of hypoxia. The objective of this study was to assess the association between different measures of SDB and BP. In 134 consecutive patients, polygraphy was performed to determine the AHI. Pulse oximetry was used to determine hypoxemic burden (time below 90% oxygen saturation [T90] and hypoxia load [HL], representing the integrated area above the curve of desaturation)...
January 16, 2018: Journal of Clinical Hypertension
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