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https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#1
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28534047/polysomnographic-heart-rate-variability-indices-and-atrial-ectopy-associated-with-incident-atrial-fibrillation-risk-in-older-community-dwelling-men
#2
Dileep Raman, Farhad Kaffashi, Li-Yung Lui, William H Sauer, Susan Redline, Peter Stone, Peggy M Cawthon, Katie L Stone, Kristine E Ensrud, Sonia Ancoli-Israel, Kenneth Loparo, Reena Mehra
BACKGROUND: Autonomic dysfunction contributes to atrial fibrillation (AF). OBJECTIVE: We hypothesized that polysomnogram (PSG)-based heart rate variability (HRV) autonomic function biomarkers are associated with incident AF and these associations are modified by measures of sleep disordered breathing (SDB). METHODS: 2350 participants of a multi-center prospective study (Outcomes of Sleep Disorders in Older Men Study) without baseline AF underwent sleep studies with incident adjudicated AF follow up (8...
May 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#3
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28526545/obstructive-sleep-apnoea-and-right-ventricular-function-a-combined-assessment-by-speckle-tracking-and-three-dimensional-echocardiography
#4
Agostino Buonauro, Maurizio Galderisi, Ciro Santoro, Angelo Canora, Maria Luisa Bocchino, Francesco Lo Iudice, Maria Lembo, Roberta Esposito, Sabrina Castaldo, Bruno Trimarco, Alessandro Sanduzzi
BACKGROUND: Little is known on right ventricular (RV) involvement in obstructive sleep apnoea (OSA). This study aimed at evaluating early RV dysfunction by standard and advanced echocardiography in OSA. METHODS: Fifty-nine OSA patients without heart failure and 29 age-matched controls underwent standard, speckle tracking and real time 3D echocardiography of right ventricle. OSA patients performed lung function tests and overnight cardio-respiratory monitoring with evaluation of apnea-hypopnea index (AHI)...
May 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28520881/sleep-apnea-disability-pension-and-cause-specific-mortality-a-nationwide-register-linkage-study
#5
Naja Hulvej Rod, Linnea Kjeldgård, Torbjörn Åkerstedt, Jane E Ferrie, Paula Salo, Jussi Vahtera, Kristina Alexanderson
Sleep apnea is a common problem affecting daily functioning and health. We evaluated associations between sleep apnea and disability pension and mortality in a prospective study of 74,543 cases of sleep apnea (60,125 outpatient; 14,418 inpatient) from the Swedish Patient Register; 2000-2009 inclusive. Cases were matched to five non-cases (n = 371,592) and followed from diagnosis/inclusion via nationwide registers until Dec 31 2010. During a mean (standard deviation) follow-up of 5.1 (2.7) years, 13% men and 21% women with inpatient sleep apnea were disability pensioned...
May 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28511486/a-review-on-detection-and-treatment-methods-of-sleep-apnea
#6
REVIEW
Rajeswari Jayaraj, Jagannath Mohan, Adalarasu Kanagasabai
This paper presents a review on detection and treatment methods of sleep apnea. Sleep apnea is the most common type of breathing-related sleep disorder. It manifests in a variety of behaviours from teeth grinding to night terrors as involuntary night-time events. The most common sleep disorders are narcolepsy, hypersomnia, sleep talking, sleep walking, and bedwetting. Sleep apnea (somnipathy) is a serious sleep disorder that pauses breathing while sleeping. Breathing pauses occur 30 times or more during sleep and it lasts for few seconds to minutes, when normal breathing starts after this pause...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28487781/hypocalciuric-hypercalcemia-due-to-impaired-renal-tubular-calcium-excretion-in-a-type-2-diabetic-patient
#7
Sihao Yang, Yan Ren, Xi Li, Haoming Tian, Zhenmei An, Tao Chen
The case we presented here was a 73-year-old gentleman, who was admitted to endocrinology department due to recurrent fatigue for 1 year. He had medical histories of type 2 diabetes for 18 years and developed CKD 4 years ago. He also suffered from dilated cardiomyopathy, and coronary heart disease, moderate sleep apnea syndrome, primary hypothyroidism, and gout. His treatment regimen was complicated which included Caltrate D and compound α-keto acid (1200 mg calcium/d). Laboratory examination revealed that his serum calcium level elevated, 24-hour urine calcium output decreased, PTH level was suppressed, and 25-hydroxyvitamin D was in normal low range...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28474128/-chronic-hypoxia-and-cardiovascular-risk-clinical-significance-of-different-forms-of-hypoxia
#8
REVIEW
U Koehler, O Hildebrandt, J Krönig, W Grimm, J Otto, W Hildebrandt, R Kinscherf
It is of fundamental importance to differentiate whether chronic hypoxia occurs intermittently or persistently. While chronic intermittent hypoxia (CIH) is found typically in patients with obstructive sleep apnea (OAS), chronic persistent hypoxia (CPH) is typically diagnosed in patients with chronic lung disease. Cardiovascular risk is markedly increased in patients with CIH compared to patients with CPH. The frequent change between oxygen desaturation and reoxygenation in patients with CIH is associated with increased hypoxic stress, increased systemic inflammation, and enhanced adrenergic activation followed by endothelial dysfunction and increased arteriosclerosis...
May 4, 2017: Herz
https://www.readbyqxmd.com/read/28467884/impairment-of-pulmonary-diffusion-correlates-with-hypoxemic-burden-in-central-sleep-apnea-heart-failure-patients
#9
Henrik Fox, Britta Koerber, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
PURPOSE: Central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) are highly prevalent in heart failure (HF) and are linked to increased mortality. Impaired pulmonary diffusion capacity [DLCO] and [KCO]) have been suggested to play a key role in CSA-CSR pathophysiology. This study investigated the relationship between HF, CSR, DLCO and KCO in well-characterized HF patients. METHODS: This prospective study included HF patients with CSR, all patients underwent full overnight polysomnography (PSG) and lung function testing...
April 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28457559/periodic-limb-movements-of-sleep-are-associated-with-an-increased-prevalence-of-atrial-fibrillation-in-patients-with-mild-sleep-disordered-breathing
#10
Jiang Xie, C Anwar A Chahal, Naima Covassin, Phillip J Schulte, Prachi Singh, Narat Srivali, Virend K Somers, Sean M Caples
BACKGROUND: Growing evidence indicates that periodic limb movements of sleep (PLMS) may be related to increased risk of developing cardiovascular disease. However, the association of PLMS with atrial fibrillation (AF) is unclear, especially in patients with sleep-disordered breathing (SDB). This study sought to investigate whether PLMS were associated with increased AF prevalence, independent of established risk factors. METHODS: We performed a cross-sectional study of patients who underwent attended polysomnography at Mayo Clinic from 2011 to 2014...
April 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28454598/the-accuracy-night-to-night-variability-and-stability-of-frontopolar-sleep-electroencephalography-biomarkers
#11
Daniel J Levendowski, Luigi Ferini-Strambi, Charlene Gamaldo, Mindy Cetel, Robert Rosenberg, Philip R Westbrook
STUDY OBJECTIVES: To assess the validity of sleep architecture and sleep continuity biomarkers obtained from a portable, multichannel forehead electroencephalography (EEG) recorder. METHODS: Forty-seven subjects simultaneously underwent polysomnography (PSG) while wearing a multichannel frontopolar EEG recording device (Sleep Profiler). The PSG recordings independently staged by 5 registered polysomnographic technologists were compared for agreement with the autoscored sleep EEG before and after expert review...
April 25, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28450367/atrial-fibrillation-epidemiology-pathophysiology-and-clinical-outcomes
#12
REVIEW
Laila Staerk, Jason A Sherer, Darae Ko, Emelia J Benjamin, Robert H Helm
The past 3 decades have been characterized by an exponential growth in knowledge and advances in the clinical treatment of atrial fibrillation (AF). It is now known that AF genesis requires a vulnerable atrial substrate and that the formation and composition of this substrate may vary depending on comorbid conditions, genetics, sex, and other factors. Population-based studies have identified numerous factors that modify the atrial substrate and increase AF susceptibility. To date, genetic studies have reported 17 independent signals for AF at 14 genomic regions...
April 28, 2017: Circulation Research
https://www.readbyqxmd.com/read/28449908/association-of-sleep-disordered-breathing-and-disturbed-cardiac-repolarization-in-patients-with-st-segment-elevation-myocardial-infarction
#13
Christoph Fisser, Alina Marcinek, Andrea Hetzenecker, Kurt Debl, Andreas Luchner, Ulrich Sterz, Jörg Priefert, Florian Zeman, Malcolm Kohler, Lars S Maier, Stefan Buchner, Michael Arzt
OBJECTIVE: In patients with ST-segment elevation myocardial infarction (STEMI), disturbed cardiac repolarization before percutaneous coronary intervention (PCI) is a risk factor for malignant ventricular arrhythmia. We tested the hypothesis that sleep-disordered breathing (SDB) in patients with STEMI is associated with disturbed cardiac repolarization. METHODS: Thirty-three patients with STEMI who underwent PCI were prospectively enrolled. To assess cardiac repolarization, the heart-rate corrected interval from the peak of the T wave to the end of the T wave (TpTec) and QTc intervals were assessed with 12-lead electrocardiography before PCI, within 24 h after PCI, and 12 weeks after PCI...
May 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28445539/restless-legs-syndrome-and-cardiovascular-diseases-a-case-control-study
#14
Marion Cholley-Roulleau, Sofiene Chenini, Séverine Béziat, Lily Guiraud, Isabelle Jaussent, Yves Dauvilliers
OBJECTIVE: The association between restless legs syndrome (RLS), cardiovascular diseases (CVD) and hypertension is inconsistent. This case-control study examined i) the association between primary RLS, CVD and hypertension by taking into account many potential confounders and ii) the influence of RLS duration, severity and treatment, sleep and depressive symptoms on CVD and hypertension in primary RLS. METHODS: A standardized questionnaire to assess the RLS phenotype, history of CVD and hypertension, sleep and depressive symptoms, drug intake and demographic/clinical features was sent to the France-Ekbom Patients Association members...
2017: PloS One
https://www.readbyqxmd.com/read/28431823/sleepiness-and-activity-in-heart-failure-patients-with-reduced-ejection-fraction-and-central-sleep-disordered-breathing
#15
Angela Atalla, Thomas W Carlisle, Anita K Simonds, Martin R Cowie, Mary J Morrell
OBJECTIVE: Patients with heart failure (HF) and sleep disordered breathing (SDB) are typically not sleepy, unlike patients without heart failure. Previous work in HF patients with obstructive SDB suggested that sleepiness was associated with a reduction in daytime activity. The consequences of predominately central SDB on sleepiness in HF are less well understood. The aim of this study was to test the hypothesis that subjective sleepiness is associated with reduced daytime activity in HF patients with central SDB, compared to those without SDB...
January 23, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28421375/obstructive-sleep-apnea-increases-the-risk-of-cardiac-events-after-percutaneous-coronary-intervention-a-meta-analysis-of-prospective-cohort-studies
#16
REVIEW
Hua Qu, Ming Guo, Ying Zhang, Da-Zhuo Shi
PURPOSE: Recent studies have shown an association between obstructive sleep apnea (OSA) and coronary artery disease; however, the association between OSA and cardiac outcomes in patients after percutaneous coronary intervention (PCI) remains undetermined. METHODS: PubMed, EMBASE, and CENTRAL were searched from inception to July 2016 for cohort studies that followed up with patients after PCI, and evaluated their overnight sleep patterns within 1 month for major adverse cardiac events (MACEs) as primary outcomes including cardiac death, non-fatal myocardial infarction (MI), and coronary revascularization and secondary outcomes including re-admission for heart failure and stroke...
April 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28417254/whom-are-we-treating-with-adaptive-servo-ventilation-a-clinical-post-hoc-analysis
#17
Maximilian V Malfertheiner, C Lerzer, L Kolb, K Heider, F Zeman, F Gfüllner, L S Maier, M Pfeifer, M Arzt
BACKGROUND: Recent evidence has shown that adaptive servo-ventilation (ASV) is contraindicated in patients with predominant central sleep apnea (CSA) and reduced left ventricular ejection fraction (LVEF ≤45%). The objective of this study was to assess the clinical usage of ASV in patients at the time-point of the release of a safety warning by type of SDB, breathing pattern and LVEF. METHODS: Patients of a cardiac and a respirology sleep center, both in Germany, who received ASV therapy were contacted between May and October 2015...
April 17, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28416405/development-validation-and-assessment-of-an-ischemic-stroke-or-transient-ischemic-attack-specific-prediction-tool-for-obstructive-sleep-apnea
#18
Jason J Sico, H Klar Yaggi, Susan Ofner, John Concato, Charles Austin, Jared Ferguson, Li Qin, Lauren Tobias, Stanley Taylor, Carlos A Vaz Fragoso, Vincent McLain, Linda S Williams, Dawn M Bravata
BACKGROUND: Screening instruments for obstructive sleep apnea (OSA), as used routinely to guide clinicians regarding patient referral for polysomnography (PSG), rely heavily on symptomatology. We sought to develop and validate a cerebrovascular disease-specific OSA prediction model less reliant on symptomatology, and to compare its performance with commonly used screening instruments within a population with ischemic stroke or transient ischemic attack (TIA). METHODS: Using data on demographic factors, anthropometric measurements, medical history, stroke severity, sleep questionnaires, and PSG from 2 independently derived, multisite, randomized trials that enrolled patients with stroke or TIA, we developed and validated a model to predict the presence of OSA (i...
April 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28408965/phospholipase-c-related-catalytically-inactive-protein-can-regulate-obesity-a-state-of-peripheral-inflammation
#19
REVIEW
Yosuke Yamawaki, Kana Oue, Satomi Shirawachi, Satoshi Asano, Kae Harada, Takashi Kanematsu
Obesity is defined as abnormal or excessive fat accumulation. Chronic inflammation in fat influences the development of obesity-related diseases. Many reports state that obesity increases the risk of morbidity in many diseases, including hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, sleep apnea, and breast, prostate and colon cancers, leading to increased mortality. Obesity is also associated with chronic neuropathologic conditions such as depression and Alzheimer's disease. However, there is strong evidence that weight loss reduces these risks, by limiting blood pressure and improving levels of serum triglycerides, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol...
February 2017: Japanese Dental Science Review
https://www.readbyqxmd.com/read/28408467/isolated-mild-sleep-associated-hypoventilation-in-children-with-down-syndrome
#20
Wai Wong, Dennis Rosen
INTRODUCTION: Children with Down syndrome (DS) have a high incidence of obstructive sleep apnea (OSA) that is often associated with hypoventilation. Little is known, however, about the prevalence of sleep-associated hypoventilation independent of OSA in these children. METHODS: Retrospective chart review of all children with DS under 18 years of age undergoing polysomnography at a tertiary care paediatric hospital during a 2-year period. Exclusion criteria were as follow: those requiring oxygen or positive-pressure ventilation; with tracheostomy, baseline hypoxia, unrepaired cyanotic heart disease, pulmonary hypertension, and cerebral palsy; or OSA with >5 obstructions/hour...
April 13, 2017: Archives of Disease in Childhood
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