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sleep apnea heart failure

Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Craig Anderson, Doug McEvoy, Jiguang Wang
OBJECTIVE: There is uncertainty over whether treatment of obstructive sleep apnea (OSA) can prevent serious cardiovascular (CV) events. DESIGN AND METHOD: SAVE (NCT00738179; ACTRN12608000409370) was designed to determine whether treatment of OSA with CPAP reduces the risk of serious CV events in patients with established CV disease. Participants were centrally randomised to CPAP treatment or usual care between 2008 and 2013,with follow-up completed late 2015 and the results will be announced in August 2016...
September 2016: Journal of Hypertension
Chooza Moon, Cynthia H Phelan, Diane R Lauver, Lisa C Bratzke
PURPOSE/OBJECTIVES: Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea and central sleep apnea, are common among patients with cardiovascular disease (CVD), but clinicians often do not pay enough attention to SRBDs. The purpose of this narrative review is to update advanced practice registered nurses on the literature focusing on the relationship between SRBDs and CVD (eg, hypertension, heart failure, coronary artery disease, arrhythmias, and stroke) and on treatments that can improve SRBDs in patients with CVD...
November 2016: Clinical Nurse Specialist CNS
Emmanuelle Berthelot, David Montani, Vincent Algalarrondo, Céline Dreyfus, Raed Rifai, Anouar Benmalek, Xavier Jais, Amir Bouchachi, Laurent Savale, Gerald Simonneau, Denis Chemla, Marc Humbert, Olivier Sitbon, Patrick Assayag
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a frequent cause of pulmonary hypertension (PH) that is not easy to differentiate from precapillary PH. We aimed to determine whether the characteristic features of the patients may help differentiate between HFpEF and precapillary-PH. METHODS AND RESULTS: Clinical and echocardiographic parameters were analyzed in 156 patients referred to our PH referral center. Right heart catheterization identified 78 PH-HFpEF patients and 78 precapillary-PH...
October 11, 2016: Journal of Cardiac Failure
Hadi A R Khafaji, Kadhim Sulaiman, Rajvir Singh, Khalid F Alhabib, Nidal Asaad, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael Almahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
BACKGROUND: The purpose of this study was to report the prevalence, clinical characteristics, contributing factors, management and outcome of patients with chronic obstructive pulmonary disease (COPD) among patients hospitalized with heart failure (HF). METHODS: Data were derived from Gulf Care (Gulf acute heart failure registry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure during February to November 2012 in seven Middle Eastern countries...
December 2015: Acute Cardiac Care
Tetyana Kendzerska, Richard S Leung, Andrea S Gershon, George Tomlinson, Najib Ayas
RATIONALE: The inter-relationships between obstructive sleep apnea (OSA) and obesity are complex and bidirectional; however, the current evidence regarding their combined effect o cardiovascular risk is limited and conflicting. Animal studies suggest that obesity may exacerbate the cardiovascular consequences of intermittent hypoxemia. OBJECTIVES: In this historical observational study, we investigated whether obesity increases the effect of nocturnal hypoxemia on the incidence of cardiovascular events in adults with suspected OSA...
September 30, 2016: Annals of the American Thoracic Society
Craig Anderson, Doug McEvoy, Jiguang Wang
OBJECTIVE: There is uncertainty over whether treatment of obstructive sleep apnea (OSA) can prevent serious cardiovascular (CV) events. DESIGN AND METHOD: SAVE (NCT00738179; ACTRN12608000409370) was designed to determine whether treatment of OSA with CPAP reduces the risk of serious CV events in patients with established CV disease. Participants were centrally randomised to CPAP treatment or usual care between 2008 and 2013,with follow-up completed late 2015 and the results will be announced in August 2016...
September 2016: Journal of Hypertension
Bindu Akkanti, Richard J Castriotta, Pavani Sayana, Emmanuel Nunez, Indranee Rajapreyar, Sachin Kumar, Sriram Nathan, Ruckshanda Majid
Congestive heart failure is one of the leading causes of morbidity and mortality in the United States, and left ventricular assist devices have revolutionized treatment of end-stage heart failure. Given that sleep apnea results in significant morbidity in these patients with advanced heart failure, practicing sleep physicians need to have an understanding of left ventricular assist devices. In this review, we summarize what is known about ventricular assist devices as they relate to sleep medicine.
August 25, 2016: Sleep Medicine Reviews
Anne-Marie Gabrielsen, Torbjørn Omland, Mette Brokner, Jan Magnus Fredheim, Jens Jordan, Sverre Lehmann, May Brit Lund, Jøran Hjelmesæth, Dag Hofsø
BACKGROUND: Obesity is a major risk factor for obstructive sleep apnea, impaired pulmonary function and heart failure, but obesity is also associated with paradoxically low levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). In subjects with severe obesity undergoing weight loss treatment, we assessed the associations between changes in severity of obstructive sleep apnea, pulmonary function and serum NT-proBNP levels. METHODS: One-year non-randomized controlled clinical trial...
2016: BMC Research Notes
Eiichi Watanabe, Ken Kiyono, Shojiro Matsui, Virend K Somers, Kan Sano, Junichiro Hayano, Tomohide Ichikawa, Mayumi Kawai, Masahide Harada, Yukio Ozaki
BACKGROUND: Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. METHODS AND RESULTS: We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011...
September 9, 2016: Journal of Cardiac Failure
R Doug McEvoy, Nick A Antic, Emma Heeley, Yuanming Luo, Qiong Ou, Xilong Zhang, Olga Mediano, Rui Chen, Luciano F Drager, Zhihong Liu, Guofang Chen, Baoliang Du, Nigel McArdle, Sutapa Mukherjee, Manjari Tripathi, Laurent Billot, Qiang Li, Geraldo Lorenzi-Filho, Ferran Barbe, Susan Redline, Jiguang Wang, Hisatomi Arima, Bruce Neal, David P White, Ron R Grunstein, Nanshan Zhong, Craig S Anderson
Background Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. Methods After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group)...
September 8, 2016: New England Journal of Medicine
Anna Kazimierczak, Paweł Krzesiński, Grzegorz Gielerak, Beata Uziębło-Życzkowska, Paweł Smurzyński, Robert Ryczek, Andrzej Cwetsch, Andrzej Skrobowski
BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG)...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yanhui Li, Mathew D Olson, Jian-Ming Li
A 79-year-old man received a dual-chamber pacemaker (Evia DR-T, Biotronik GmbH, Berlin, Germany) for syncope and sick sinus syndrome with paroxysmal atrial fibrillation. His past medical history included systemic hypertension, hyperlipidemia, coronary artery disease, diabetes mellitus type II, obstructive sleep apnea, diffuse lung disease, diastolic congestive heart failure with preserved systolic function. This article is protected by copyright. All rights reserved.
August 24, 2016: Pacing and Clinical Electrophysiology: PACE
Loheetha Ragupathi, Drew Johnson, Gregary D Marhefka
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites...
August 2016: Texas Heart Institute Journal
Rami Khayat, Adam Pleister
Obstructive sleep apnea (OSA) is present in up to 25% of otherwise healthy individuals. OSA is associated with intermittent hypoxia, oxidative stress, sympathetic activation, and an inflammatory response. These perturbations mediate the role of OSA as an independent and modifiable risk factor for cardiovascular disease (CVD). OSA can induce CVD or accelerate the progression of CVD into an end-stage disorder, including heart failure and stroke. Current clinical recommendations are based on existing clinical trial data and the clinical experience of our program; current and future clinical trials will help to optimize management of OSA in the setting of CVD...
September 2016: Sleep Medicine Clinics
Carmen Pizarro, Fabian van Essen, Fabian Linnhoff, Robert Schueler, Christoph Hammerstingl, Georg Nickenig, Dirk Skowasch, Marcel Weber
BACKGROUND: COPD and congestive heart failure represent two disease entities of growing global burden that share common etiological features. Therefore, we aimed to identify the degree of left ventricular (LV) dysfunction in COPD as a function of COPD severity stages and concurrently placed particular emphasis on the presence of overlapping obstructive sleep apnea (OSA). METHODS: A total of 85 COPD outpatients (64.1±10.4 years, 54.1% males) and 20 controls, matched for age, sex, and smoking habits, underwent speckle tracking echocardiography for LV longitudinal strain imaging...
2016: International Journal of Chronic Obstructive Pulmonary Disease
P Talarowska, A Segiet, M Rozanska, O Mozenska, D A Kosior
OBJECTIVE: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Individuals with OSA are at increased risk of cardiovascular diseases such as arterial hypertension (HTN), heart failure, stroke and pulmonary hypertension. Detailed data regarding hypotensive therapy and its effectiveness in patients with HTN and OSA are lacking. The aim of the study was to characterize in details hypotensive therapy in patients with HTN and OSA. DESIGN AND METHOD: We retrospectively analyzed 1270 patients who were treated in our outpatient sleep apnea clinic...
September 2016: Journal of Hypertension
Elise Belaidi, Jessica Morand, Emmanuelle Gras, Jean-Louis Pépin, Diane Godin-Ribuot
Obstructive sleep apnea (OSA) is now recognized as an independent and important risk factor for cardiovascular diseases such as hypertension, coronary heart disease, heart failure and stroke. Clinical and experimental data have confirmed that intermittent hypoxia is a major contributor to these deleterious consequences. The repetitive occurrence of hypoxia-reoxygenation sequences generates significant amounts of free radicals, particularly in moderate to severe OSA patients. Moreover, in addition to hypoxia, reactive oxygen species (ROS) are potential inducers of the hypoxia inducible transcription factor-1 (HIF-1) that promotes the transcription of numerous adaptive genes some of which being deleterious for the cardiovascular system, such as the endothelin-1 gene...
August 2, 2016: Pharmacology & Therapeutics
Philipp Fassbender, Frank Herbstreit, Matthias Eikermann, Helmut Teschler, Jürgen Peters
BACKGROUND: Obstructive sleep apnea (OSA) is a common disorder of breathing but is probably underappreciated as a perioperative risk factor. METHODS: This review is based on pertinent articles, published up to 15 August 2015, that were retrieved by a selective search in PubMed based on the terms "sleep apnea AND anesthesia" OR "sleep apnea AND pathophysiology." The guidelines of multiple specialty societies were considered as well. RESULTS: OSA is characterized by phases of upper airway obstruction accompanied by apnea/hypoventilation, with hypoxemia, hypercapnia, and recurrent overactivation of the sympathetic nervous system...
July 11, 2016: Deutsches Ärzteblatt International
Jiang Xie, Fatima H Sert Kuniyoshi, Naima Covassin, Prachi Singh, Apoor S Gami, Shihan Wang, C Anwar A Chahal, Yongxiang Wei, Virend K Somers
BACKGROUND: Obstructive sleep apnea (OSA) is an important risk factor for the development of cardiovascular diseases including myocardial infarction (MI). The aim of this study was to investigate the effects of OSA on prognosis after MI, and to determine which specific measures of OSA severity best predicted outcomes. METHODS AND RESULTS: We performed a prospective study, in which 112 patients without a prior diagnosis of sleep apnea underwent comprehensive polysomnography within a median of 7 days after MI...
2016: Journal of the American Heart Association
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