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https://www.readbyqxmd.com/read/29208334/factors-influencing-recurrent-emergency-department-visits-for-epistaxis-in-the-elderly
#1
Mohamad R Chaaban, Dong Zhang, Vicente Resto, James S Goodwin
OBJECTIVE: Our objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly. METHODS: We used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months. We assessed the rates of ED visits for recurrent epistaxis in the 12 months following the incident visit...
December 2, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29198416/sleep-disordered-breathing-and-epicardial-adipose-tissue-in-patients-with-heart-failure
#2
V Parisi, S Paolillo, G Rengo, R Formisano, L Petraglia, F Grieco, C D'Amore, S Dellegrottaglie, C Marciano, N Ferrara, D Leosco, P P Filardi
BACKGROUND AND AIMS: Sleep-disordered breathing (SDB) is common in patients with heart failure (HF), contributes to the progression of cardiac disease, and is associated with adverse prognosis. Previous evidence indicates that epicardial adipose tissue (EAT) is independently associated with sleep apnea in obese individuals. We explored the relationship between SDB and EAT in HF patients. METHODS AND RESULTS: EAT thickness was assessed by echocardiography in 66 patients with systolic HF undergoing nocturnal cardiorespiratory monitoring...
October 13, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29187390/phenotyping-of-sleep-disordered-breathing-in-patients-with-chronic-heart-failure-with-reduced-ejection-fraction-the-schlahf-registry
#3
Michael Arzt, Olaf Oldenburg, Andrea Graml, Erland Erdmann, Helmut Teschler, Karl Wegscheider, Anna Suling, Holger Woehrle
BACKGROUND: Different sleep-disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA-CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline-based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA-CSA, as well as periodic breathing, in HFrEF patients with SDB. METHODS AND RESULTS: The German SchlaHF registry enrolled patients with HFrEF receiving guideline-based therapies, who underwent portable SDB monitoring...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29181786/early-therapeutic-effects-of-adaptive-servo-ventilation-on-cardiac-sympathetic-nervous-function-in-patients-with-heart-failure-evaluated-using-a-combination-of-11c-hed-pet-and-123i-mibg-spect
#4
Yusuke Tokuda, Mamoru Sakakibara, Keiichiro Yoshinaga, Shiro Yamada, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Keiji Noguchi, Osamu Manabe, Nagara Tamaki, Hiroyuki Tsutsui
RATIONALE: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57...
November 27, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29168167/interdependent-feedback-regulation-of-breathing-by-the-carotid-bodies-and-the-retrotrapezoid-nucleus
#5
Patrice G Guyenet, Douglas A Bayliss, Ruth L Stornetta, Roy Kanbar, Yingtang Shi, Benjamin B Holloway, George M P R Souza, Tyler M Basting, Stephen B G Abbott, Ian C Wenker
The retrotrapezoid nucleus, RTN, regulates breathing in a CO2 and state-dependent manner. RTN neurons are glutamatergic and innervate principally the respiratory pattern generator; they regulate multiple aspects of breathing, including active expiration, and maintain breathing automaticity during non-REM sleep. RTN neurons encode arterial PCO2 /pH via cell-autonomous and paracrine mechanisms, and via input from other CO2 -responsive neurons. In short, RTN neurons are a pivotal structure for breathing automaticity and arterial PCO2 homeostasis...
November 22, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29167620/obstructive-sleep-apnea-independently-increases-the-incidence-of-heart-failure-and-major-adverse-cardiac-events-a-retrospective-population-based-follow-up-study
#6
Yu-Sheng Lin, Pi-Hua Liu, Pao-Hsien Chu
Background: Obstructive sleep apnea (OSA) is common in heart failure (HF) patients and exacerbates the outcome of this chronic disease. However, the frequency of HF arising from OSA is varied, with little supporting literature. Here, we aimed to clarify the incidence risk of HF and major adverse cardiac events (MACEs) in OSA patients from the Taiwan large database. Methods and Results: From 2000-2010, a total of 2699 newly diagnosed OSA patients after polysomnographic study and 13,490 non-OSA patients utilizing 1:5 matching was enrolled and followed to 2011...
November 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29162360/sleep-disordered-breathing-in-heart-failure-the-state-of-the-art-after-the-serve-hf-trial
#7
REVIEW
João Carmo, Inês Araújo, Filipa Marques, Cândida Fonseca
Heart failure (HF) is one of the most prevalent conditions worldwide and despite therapeutic advances, its prognosis remains poor. Among the multiple comorbidities in HF, sleep-disordered breathing (SDB) is frequent and worsens the prognosis. Preliminary observational studies suggested that treatment of SDB could modify the prognosis of HF, and the issue has gained importance in recent years. The diagnosis of SDB is expensive, slow and suboptimal, and there is thus a need for screening devices that are easier to use and validated in this population...
November 18, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29142091/physiological-and-pathophysiological-firing-properties-of-single-postganglionic-sympathetic-neurons-in-humans
#8
Vaughan G Macefield, B Gunnar Wallin
It has long been known from microneurographic recordings in human subjects that activity of postganglionic sympathetic axons occurs as spontaneous bursts, with muscle sympathetic nerve activity (MSNA) exhibiting strong cardiac rhythmicity via the baroreflex and skin sympathetic nerve activity (SSNA) showing much weaker cardiac modulation. Here we review the firing properties of single sympathetic neurons, obtained using highly selective microelectrodes. Individual vasoconstrictor neurons supplying muscle or skin, or sudomotor neurones supplying sweat glands, always discharge with a low firing probability (~30%) and at very low frequencies (~0...
November 15, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29121095/the-pedunculopontine-tegmentum-controls-renal-sympathetic-nerve-activity-and-cardiorespiratory-activities-in-nembutal-anesthetized-rats
#9
Anne M Fink, Caron Dean, Mariann R Piano, David W Carley
Elevated renal sympathetic nerve activity (RSNA) accompanies a variety of complex disorders, including obstructive sleep apnea, heart failure, and chronic kidney disease. Understanding pathophysiologic renal mechanisms is important for determining why hypertension is both a common sequelae and a predisposing factor of these disorders. The role of the brainstem in regulating RSNA remains incompletely understood. The pedunculopontine tegmentum (PPT) is known for regulating behaviors including alertness, locomotion, and rapid eye movement sleep...
2017: PloS One
https://www.readbyqxmd.com/read/29112823/obstructive-sleep-apnea-during-rapid-eye-movement-sleep-and-cardiovascular-disease
#10
R Nisha Aurora, Ciprian Crainiceanu, Daniel J Gottlieb, Ji Soo Kim, Naresh M Punjabi
BACKGROUND: Obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep is a common disorder. Data on whether OSA that occurs predominantly during REM sleep is associated with health outcomes are limited. The present study examined the association between OSA during REM sleep and a composite cardiovascular endpoint in a community sample with and without prevalent cardiovascular disease. METHODOLOGY: Full montage home polysomnography was conducted as part of the Sleep Heart Health Study...
November 7, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29111106/2017-comprehensive-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-heart-failure
#11
Justin A Ezekowitz, Eileen O'Meara, Michael A McDonald, Howard Abrams, Michael Chan, Anique Ducharme, Nadia Giannetti, Adam Grzeslo, Peter G Hamilton, George A Heckman, Jonathan G Howlett, Sheri L Koshman, Serge Lepage, Robert S McKelvie, Gordon W Moe, Miroslaw Rajda, Elizabeth Swiggum, Sean A Virani, Shelley Zieroth, Abdul Al-Hesayen, Alain Cohen-Solal, Michel D'Astous, Sabe De, Estrellita Estrella-Holder, Stephen Fremes, Lee Green, Haissam Haddad, Karen Harkness, Adrian F Hernandez, Simon Kouz, Marie-Hélène LeBlanc, Frederick A Masoudi, Heather J Ross, Andre Roussin, Bruce Sussex
Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#12
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29108893/bariatric-surgery-as-a-treatment-for-heart-failure-review-of-the-literature-and-potential-mechanisms
#13
Tammy L Kindel, Jennifer L Strande
Heart failure due to severe obesity is a complex disease due to multiple mechanisms, including increased body mass, inflammation, and impaired cardiac metabolism that is complicated by obesity-associated co-morbidities, such as type 2 diabetes and obstructive sleep apnea. Bariatric surgery significantly improves cardiac geometry, function, and symptoms related to obesity cardiomyopathy. There is a consistently positive impact of bariatric surgery on diastolic function with the potential to significantly improve systolic function as measured by ejection fraction in patients with advanced heart failure...
October 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29108611/positive-airway-pressure-therapy-for-hyperventilatory-central-sleep%C3%A2-apnea-idiopathic-heart-failure-cerebrovascular-disease-and-high-altitude
#14
REVIEW
Shahrokh Javaheri, Lee K Brown
Central sleep apnea (CSA) and Hunter-Cheyne-Stokes breathing (HCSB) are caused by failure of the pontomedullary pacemaker generating breathing rhythm. CSA/HCSB may complicate several disorders causing recurrent arousals and desaturations. Common causes of CSA in adults are congestive heart failure, stroke, and chronic use of opioids; opioids have hypoventilatory effects. Diagnosis and treatment of hyperventilatory CSA may improve quality of life, and, when associated with heart failure or cerebrovascular disease, reduce morbidity and perhaps mortality...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29102807/microstructural-cerebral-lesions-are-associated-with-the-severity-of-central-sleep-apnea-with-cheyne-stokes-respiration-in-heart-failure-and-are-modified-by-pap-therapy
#15
Anna Heidbreder, Jens Spießhöfer, Jörg Stypmann, Matthias Boentert, Peter Young, Thomas Duning
This study investigated the association of microstructural cerebral lesions with central sleep apnea with Cheyne-Stokes-respiration (CSA-CSR) in heart failure (HF) patients and the effect of positive airway pressure therapy (PAP) of CSA-CSR on these lesions. PAP-therapy was initiated in patients with HF with midrange and with reduced ejection fraction (NYHA≥II; left ventricular ejection fraction <50%) and proven CSA-CSR. Cerebral magnetic resonance imaging (MRI) scans at 3T including diffusion tensor imaging were obtained before and after 4 months of PAP-therapy...
November 2, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29071163/resolution-of-periodic-breathing-in-a-child-with-idiopathic-pulmonary-arterial-hypertension
#16
Saadoun Bin-Hasan, Abdullah Khayat, Tilman Humpl, Janette T Reyes, Suhail Al-Saleh
Central sleep apnea (CSA) and periodic breathing are unusual findings described in pediatric patients with congestive heart failure. However, CSA has not been reported in children with pulmonary hypertension. We hereby report on a 10-year-old girl with idiopathic pulmonary arterial hypertension who had frequent central events in a periodic breathing fashion seen in her polysomnography, which was normalized following medical treatment leading to improvement of the pulmonary pressures.
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29065958/dissociation-of-objective-and-subjective-daytime-sleepiness-and-biomarkers-of-systemic-inflammation-in-sleep-disordered-breathing-and-systolic-heart-failure
#17
Reena Mehra, Lu Wang, Noah Andrews, W H Wilson Tang, James B Young, Shahrokh Javaheri, Nancy Foldvary-Schaefer
STUDY OBJECTIVES: Subjective versus objective sleepiness in heart failure (HF) remains understudied; therefore, we sought to examine the association of these measures and interrelationships with biochemical markers. METHODS: Participants with stable systolic HF recruited from a clinic-based program underwent attended polysomnography, Multiple Sleep Latency Testing, questionnaire data collection including Epworth Sleepiness Scale (ESS), and morning phlebotomy for biochemical markers...
October 18, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29065956/distinct-patterns-of-hyperpnea-during-cheyne-stokes-respiration-implication-for-cardiac-function-in-patients-with-heart-failure
#18
Elisa Perger, Toru Inami, Owen D Lyons, Hisham Alshaer, Stephanie Smith, John S Floras, Alexander G Logan, Michael Arzt, Joaquin Duran Cantolla, Diego Delgado, Michael Fitzpatrick, John Fleetham, Takatoshi Kasai, R John Kimoff, Richard S T Leung, Geraldo Lorenzi Filho, Pierre Mayer, Lisa Mielniczuk, Debra L Morrison, Gianfranco Parati, Sairam Parthasarathy, Stefania Redolfi, Clodagh M Ryan, Frederic Series, George A Tomlinson, Anna Woo, T Douglas Bradley
STUDY OBJECTIVES: In heart failure (HF), we observed two patterns of hyperpnea during Cheyne-Stokes respiration with central sleep apnea (CSR-CSA): a positive pattern where end-expiratory lung volume remains at or above functional residual capacity, and a negative pattern where it falls below functional residual capacity. We hypothesized the negative pattern is associated with worse HF. METHODS: Patients with HF underwent polysomnography. During CSR-CSA, hyperpnea, apnea-hyperpnea cycle, and lung to finger circulation times (LFCT) were measured...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29060172/monitoring-of-nocturnal-central-sleep-apnea-in-heart-failure-patients-using-noncontact-respiratory-differences
#19
Rami N Khushaba, Jeff Armitstead, Klaus Schindhelm
Monitoring of respiration patterns allows the early detection of various breathing disorders and may better identify those at risk for adverse acute outcomes in a variety of clinical settings. In this paper, we report on the use of SleepMinder (SM), a bedside non-contact Doppler-based biomotion recording sensor, to monitor remotely the nocturnal respiration patterns of 50 patients with systolic Heart failure (HF) while undergoing a lab based Polysomnography (PSG) test. A new respiration rate (RR) monitoring algorithm was developed based on the collected overnight radar signals...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#20
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
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