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https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#1
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/29425382/the-beneficial-effect-of-weight-reduction-on-adverse-cardiovascular-outcomes-following-bariatric-surgery-is-attenuated-in-patients-with-obstructive-sleep-apnea
#2
Ahmed Dalmar, Maharaj Singh, Bennet Pandey, Christopher Stoming, Zoe Heis, Khawaja Afzal Ammar, M Fuad Jan, Indrajit Choudhuri, Thomas Y Chua, Jasbir Sra, A Jamil Tajik, Arshad Jahangir
Weight loss after bariatric surgery is associated with reduction in adverse cardiovascular outcomes; however, the impact of obstructive sleep apnea (OSA) on reduction of cardiovascular outcomes after bariatric surgery in morbidly obese patients is not known. We retrospectively assessed differences in cardiovascular events after laparoscopic adjustable gastric banding (LAGB)-induced weight loss in patients with and without OSA before and after propensity score matching for age, sex, body mass index (BMI), and major comorbidities between the two groups and determined predictors of poor outcomes...
February 7, 2018: Sleep
https://www.readbyqxmd.com/read/29413512/the-revised-gold-2017-copd-categorization-in-relation-to-comorbidities
#3
Kathrin Kahnert, Peter Alter, David Young, Tanja Lucke, Joachim Heinrich, Rudolf M Huber, Jürgen Behr, Margarethe Wacker, Frank Biertz, Henrik Watz, Robert Bals, Tobias Welte, Hubert Wirtz, Felix Herth, Jørgen Vestbo, Emiel F Wouters, Claus F Vogelmeier, Rudolf A Jörres
INTRODUCTION: The COPD classification proposed by the Global Initiative for Obstructive Lung Disease was recently revised, and the A to D grouping is now based on symptoms and exacerbations only. Potential associations with comorbidities have not been assessed so far. Thus the aim of the present study was to determine the relationship between the revised (2017) GOLD groups A-D and major comorbidities. METHODS: We used baseline data from the COPD cohort COSYCONET...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#4
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/29387467/sleep-disordered-breathing-during-congestive-heart-failure-to-intervene-or-not-to-intervene
#5
Ali Valika, Maria Rosa Costanzo
Sleep-disordered breathing is common in heart failure patients and is associated with increased morbidity and mortality. Central sleep apnea occurs more commonly in heart failure-reduced ejection fraction, and obstructive sleep apnea occurs more frequently in heart failure with preserved ejection fraction. Although the two types of sleep-disordered breathing have distinct pathophysiologic mechanisms, both contribute to abnormal cardiovascular consequences. Treatment with continuous positive airway pressure for obstructive sleep apnea in heart failure has been well defined, whereas treatment strategies for central sleep apnea in heart failure continue to evolve...
November 2017: Cardiac failure review
https://www.readbyqxmd.com/read/29383868/impact-of-testosterone-replacement-therapy-on-thromboembolism-heart-disease-and-obstructive-sleep-apnea-in-men
#6
Alexander P Cole, Julian Hanske, Wei Jiang, Nicollette K Kwon, Stuart R Lipsitz, Martin N Kathrins, Peter A Learn, Maxine Sun, Adil H Haider, Shehzad S Basaria, Quoc-Dien Trinh
OBJECTIVES: To assess the association of TRT with thromboembolism, cardiovascular disease (stroke, coronary artery disease, and heart failure) and obstructive sleep apnea (OSA). METHODS: A cohort of 3,422 male United States military service members, retirees and their dependents, aged 40-64 was identified, who were prescribed TRT between 2006-2010 for low testosterone. Men in this cohort were matched on a 1:1 basis by age and comorbidities to men without a prescription for TRT...
January 30, 2018: BJU International
https://www.readbyqxmd.com/read/29372314/adaptive-servo-ventilation-and-sleep-quality-in-treatment-emergent-central-sleep-apnea-and-central-sleep-apnea-in-patients-with-heart-disease-and-preserved-ejection-fraction
#7
Katharina Heider, Michael Arzt, Christoph Lerzer, Leonie Kolb, Michael Pfeifer, Lars S Maier, Florian Gfüllner, Maximilian Valentin Malfertheiner
BACKGROUND: Reduced sleep quality is associated with impaired quality of life and increased mortality in patients with heart failure. The aim of this study was to observe changes in sleep fragmentation and sleep quality in patients with heart disease and preserved left ventricular ejection fraction (pEF) treated with adaptive servo-ventilation (ASV) therapy for treatment of emergent central sleep apnea (TECSA) or central sleep apnea (CSA). METHODS: 114 patients with structural heart disease and pEF introduced to ASV therapy between 2010 and 2015 were retrospectively analyzed...
January 25, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29344749/diagnosis-of-sleep-apnea-in-patients-with-stable-chronic-heart-failure-using-a-portable-sleep-test-diagnostic-device
#8
Inês Araújo, Filipa Marques, Sandra André, Manuel Araújo, Sara Marques, Rita Ferreira, Patrícia Moniz, Margarida Proença, Pedro Borrego, Cândida Fonseca
PURPOSE: ApneaLink is a portable device for the screening of sleep apnea, a prevalent and underdiagnosed comorbidity in heart failure patients. A prospective cross-sectional study in patients with chronic heart failure was carried out to assess the sensitivity and specificity of apnea-hypopnea index (AHI) measurements using ApneaLink against the standard polysomnography test. METHODS: Adult patients with a prior hospitalization in an acute heart failure hospital unit were recruited for the study...
January 17, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29261679/distinct-impacts-of-sleep-disordered-breathing-on-glycemic-variability-in-patients-with-and-without-diabetes-mellitus
#9
Kei Nakata, Takayuki Miki, Masaya Tanno, Hirofumi Ohnishi, Toshiyuki Yano, Atsuko Muranaka, Tatsuya Sato, Hiroto Oshima, Yuki Tatekoshi, Masashi Mizuno, Koki Abe, Tetsuji Miura
BACKGROUND: Sleep-disordered breathing (SDB) is highly prevalent in patients with diabetes mellitus (DM) and heart failure (HF) and contributes to poor cardiovascular outcomes. Enlarged glycemic variability (GV) is a risk factor of cardiac events independently of average blood glucose level, but the influence of SDB on GV is uncertain. In this study, we examined whether the impact of SDB on GV is modified by the presence of DM with or without HF. METHODS AND RESULTS: Two hundred three patients (67...
2017: PloS One
https://www.readbyqxmd.com/read/29250231/laser-catheter-ablation-of-long-lasting-persistent-atrial-fibrillation-longterm-results
#10
Helmut Weber, Michaela Sagerer-Gerhardt, Armin Heinze
Catheter ablation of atrial fibrillation (AF) is a current therapeutic option but its efficacy for the treatment of long-lasting persistent AF (l-lpAF) remains suboptimal. We tested the laser method as an alternative for catheter ablation of l-lpAF by using an open-irrigated electrode laser mapping and ablation (ELMA) catheter. Laser ablation was attempted in 48 patients aged 50-81 years (69 ± 7.6 y, female = 28) with drug resistant (3.5 trials) l-lpAF (≥12 months). All of the patients had comorbidities: congestive heart failure NYHA II-III (100%), hypertension 29 (60%), coronary artery disease 19 (40%), and heart valve defect 17 (35%)...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29249245/relationship-between-sleep-disordered-breathing-and-renal-dysfunction-in-acute-coronary-syndrome
#11
Masayoshi Kiyokuni, Chika Kawashima, Masaaki Konishi, Kentaro Sakamaki, Kiwamu Iwata, Naoki Nakayama, Naohiro Komura, Masami Kosuge, Teruyasu Sugano, Tomoaki Ishigami, Tsutomu Endo, Toshiyuki Ishikawa, Takeharu Yamanaka, Kazuo Kimura, Kouichi Tamura
BACKGROUND: Sleep-disordered breathing (SDB) is associated with cardiovascular complications. However, the effect of SDB on renal function in patients with acute coronary syndrome (ACS) treated by percutaneous coronary intervention (PCI) remains unclear. METHODS: We enrolled 154 consecutive ACS patients without heart failure. A sleep study was performed immediately after PCI. RESULTS: The mean apnea-hypopnea index (AHI) was 16.4±13.1, and 33 patients (21%) had severe SDB, defined as AHI≥25...
February 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29223500/impact-of-chronic-kidney-disease-on-mortality-in-adults-undergoing-balloon-aortic-valvuloplasty
#12
Puja B Parikh, Samantha Novotny, Allen Jeremias, Javed Butler, Jie Yang, Donglei Yin, Luis Gruberg
BACKGROUND: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV. METHODS: The Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29208334/factors-influencing-recurrent-emergency-department-visits-for-epistaxis-in-the-elderly
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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 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
#20
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
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