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https://www.readbyqxmd.com/read/28215031/orexin-a-missing-link-between-sleep-disorders-and-heart-failure
#1
REVIEW
Stephen Pan, Carolina S Cabral, Euan A Ashley, Marco V Perez
PURPOSE OF REVIEW: Sleep disorders represent a significant comorbidity in the heart failure population, and there is mounting evidence that treatment of sleep disorders such as obstructive sleep apnea can significantly improve cardiac function. However, the link between these two disorders is still not entirely clear. RECENT FINDINGS: Recently, a novel neurohormonal pathway has been elucidated involving signaling molecules now collectively known as the orexins, which have been implicated in regulating autonomic function during sleep/wake cycles...
February 18, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28213507/effect-of-sleep-disordered-breathing-on-appropriate-implantable-cardioverter-defibrillator-therapy-in-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#2
Younghoon Kwon, Ryan J Koene, Osung Kwon, Jessica V Kealhofer, Selcuk Adabag, Sue Duval
BACKGROUND: Patients with heart failure and reduced ejection fraction are at increased risk of malignant ventricular arrhythmias. Implantable cardioverter-defibrillator (ICD) is recommended to prevent sudden cardiac death in some of these patients. Sleep-disordered breathing (SDB) is highly prevalent in this population and may impact arrhythmogenicity. We performed a systematic review and meta-analysis of prospective studies that assessed the impact of SDB on ICD therapy. METHODS AND RESULTS: Relevant prospective studies were identified in the Ovid MEDLINE, EMBASE, and Google Scholar databases...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28211952/long-term-experience-with-first-generation-implantable-neurostimulation-device-in-central-sleep-apnea-treatment
#3
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg, Klaus-Jürgen Gutleben
BACKGROUND: Sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) are associated with shorter survival in patients with heart failure (HF). A novel treatment method for this patient group is unilateral phrenic nerve stimulation by the remedē® system, a transvenously implantable neurostimulation device, which has recently been studied in a large randomized, controlled trial. Previous literature has shown efficacy and safety of the treatment with this first-generation device, but hardly any data is available on long-term clinical parameters, the remedē® device's battery lifetime, device exchangeability, lead position stability, surgical accessibility and manageability...
February 17, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28210325/hot-topics-from-the-assemblies
#4
(no author information available yet)
Cowie et al. present the results of the international, multicentre, randomised, parallel-group SERVE-HF (Treatment of sleep-disordered breathing with predominant central sleep apnea by adaptive servo ventilation in patients with heart failure) trial, which investigated the effects of adding adaptive servo-ventilation (ASV) to guideline based medical management on survival and cardiovascular outcomes in patients with heart failure defined as reduced ejection fraction (<45%) and predominant central sleep apnoea (CSA)...
December 2016: Breathe
https://www.readbyqxmd.com/read/28209264/patient-travel-for-bariatric-surgery-does-distance-matter
#5
J Hunter Mehaffey, Alex D Michaels, Mathew G Mullen, Max O Meneveau, John R Pender, Peter T Hallowell
BACKGROUND: Increasingly, patients are faced with greater travel distances to undergo bariatric surgery at high-volume centers. OBJECTIVES: This study sought to evaluate the impact of travel distance on access to care and outcomes after bariatric surgery. SETTING: Patients who underwent Roux-en-Y gastric bypass at an academic bariatric surgery center from 1985 to 2004 were examined and stratified by patient travel distance. METHODS: Univariate analyses were performed for preoperative risk factors, 30-day complications, and long-term (10-yr) weight loss between "local," defined as<1 hour of travel time, and "regional," defined as>1 hour of travel time...
December 28, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28209226/sleep-apnea-types-mechanisms-and-clinical-cardiovascular-consequences
#6
REVIEW
Shahrokh Javaheri, Ferran Barbe, Francisco Campos-Rodriguez, Jerome A Dempsey, Rami Khayat, Sogol Javaheri, Atul Malhotra, Miguel A Martinez-Garcia, Reena Mehra, Allan I Pack, Vsevolod Y Polotsky, Susan Redline, Virend K Somers
Sleep apnea is highly prevalent in patients with cardiovascular disease. These disordered breathing events are associated with a profile of perturbations that include intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, all of which are critical mediators of cardiovascular disease. Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Several discoveries in the pathogenesis, along with developments in the treatment of sleep apnea, have accumulated in recent years...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28188451/patients-with-cheyne-stokes-respiration-and-heart-failure-patient-tolerance-after-three-month-discontinuation-of-treatment-with-adaptive-servo-ventilation
#7
Arild Hetland, Tøri Vigeland Lerum, Kristina H Haugaa, Thor Edvardsen
The recent SERVE HF study concluded that patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) have increased mortality when treated with adaptive servo-ventilation (ASV). We, therefore, wanted to explore if these patients tolerated discontinuation of ASV treatment. The study was a prospective post-ASV treatment observational design with a 3-month follow-up period. 14 patients from our outpatient clinic, all male, were originally diagnosed with CHF and Cheyne-Stokes respiration, which is a clinical form of central sleep apnea...
February 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28178694/resolution-of-cheyne-stokes-respiration-after-treatment-of-heart-failure-with-sacubitril-valsartan-a-first-case-report
#8
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF), and is known to be associated with a worse prognosis. The severity of central sleep apnea is thought to mirror cardiac dysfunction. The novel angiotensin receptor-neprilysin inhibitor (ARNi) sacubitril has been shown to improve HF, but a relationship between treatment with ARNi and the severity of SDB has not yet been investigated. We report the case of a 71-year-old male with HF and SDB. Treatment with sacubitril/valsartan was associated with improved cardiac function, as shown by a reduction in the level of N-terminal prohormone of brain natriuretic peptide from 3,249 to 1,720 pg/mL, and an improvement in left-ventricular ejection fraction from 30 to 35%...
February 9, 2017: Cardiology
https://www.readbyqxmd.com/read/28167915/the-role-of-acute-intermittent-hypoxia-in-neutrophil-generated-superoxide-sympathovagal-balance-and-vascular-function-in-healthy-subjects
#9
Germana P L Almeida, Ivani C Trombetta, Felipe X Cepeda, Elaine Hatanaka, Rui Curi, Cristiano Mostarda, Maria C Irigoyen, José A S Barreto-Filho, Eduardo M Krieger, Fernanda M Consolim-Colombo
Introduction: Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology. However, the impact of acute intermittent HPX-reoxygenation on markers of oxidative stress in healthy individuals remains to be fully understood...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28159487/the-use-of-pulse-transit-time-in-pediatric-sleep-studies-a-systematic-review
#10
REVIEW
Laurelle A Smith, Patrick J Dawes, Barbara C Galland
As a surrogate measure of blood pressure, pulse transit time (PTT) is commonly used in studies investigating arterial function and respiratory sleep disturbance. A systematic search of the literature was conducted with the aim of reviewing the usefulness of the technique within pediatric sleep studies. All studies that used PTT as a diagnostic tool during sleep in infants, children or adolescents were considered. The search yielded 425 articles, of which 21 full-text articles met inclusion criteria, the majority reporting on obstructive sleep apnea (OSA)...
November 30, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28159090/management-of-sleep-apnea-syndromes-in-heart-failure
#11
REVIEW
Bernardo J Selim, Kannan Ramar
Central sleep apnea (CSA) and obstructive sleep apnea (OSA) are prevalent in heart failure (HF) and associated with a worse prognosis. Nocturnal oxygen therapy may decrease CSA events, sympathetic tone, and improve left ventricular ejection fraction, although mortality benefit is unknown. Although treatment of OSA in patients with HF is recommended, therapy for CSA remains controversial. Continuous positive airway pressure use in HF-CSA may improve respiratory events, hemodynamics, and exercise capacity, but not mortality...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28155102/stratification-of-cardiovascular-risk-in-patients-with-atrial-fibrillation-and-obstructive-sleep-apnea-validity-of-the-2mace-score
#12
Anna E Platek, Filip M Szymanski, Krzysztof J Filipiak, Alicja Dudzik-Plocica, Bartosz Krzowski, Grzegorz Karpinski
BACKGROUND: Risk stratification in patients with atrial fibrillation (AF) is critically important because this group is at high risk of mortality and morbidity. One of the comorbidities potentially affecting thromboembolic and total cardiovascular risk is obstructive sleep apnea (OSA). The aim of this study was to determine whether or not patients with atrial fibrillation and concomitant obstructive sleep apnea have a higher predicted cardiovascular risk than those without sleep-disordered breathing...
February 2, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28154583/renal-denervation-for-chronic-heart-failure-background-and-pathophysiological-rationale
#13
REVIEW
Michael Böhm, Sebastian Ewen, Felix Mahfoud
The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28153217/nocturnal-heart-rate-variation-in-diabetic-and-non-diabetic-patients%C3%A2-with-sleep-apnea-syndrome
#14
Babak Amra, Mohaddeseh Behjati, Thomas Penzel, Ingo Fietze, Christoph Schoebel, Nizal Sarrafzadegan
OBJECTIVES: Heart rate variability (HRV) analysis is used for the evaluation of autonomic function in the cardiovascular system. Decreased HRV is associated with disorders affecting the autonomous system such as diabetes mellitus (DM) and obstructive sleep apnea (OSA). Previous studies have shown an association between OSA and DM. However, the interrelationships of HRV with OSA and DM are not well known. The aim of this study was to assess nocturnal HRV in patients who suffered from OSA with and without DM...
January 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28150280/galectin-3-is-associated-with-coronary-plaque-burden-and-obstructive-sleep-apnea-syndrome-severity
#15
Hamdi Pusuroglu, Umut Somuncu, Ismail Bolat, Ozgur Akgul, Vesile Ornek, Hayriye Ak Yıldırım, Emre Akkaya, Huseyin Karakurt, Aydın Yıldırım, Ayfer Utku Savaş
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is reported to be associated with hypertension, coronary artery disease, atrial fibrillation, and heart failure. Galectin-3 plays an important role in the regulation of inflammation, development of cardiac fibrosis and remodeling. A significant relationship between galectin-3 and the total number of coronary plaques and the macrocalcified plaque structures of patients with type 2 DM has been reported. AIM: The aim of this study was to investigate the association between galectin-3 level and coronary plaque burden as well as OSAS severity in patients with obstructive sleep apnea syndrome...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28146212/impact-of-high-risk-for-obstructive-sleep-apnea-on-survival-after-acute-coronary-syndrome-insights-from-the-erico-registry
#16
Flavia C Maia, Alessandra C Goulart, Luciano F Drager, Henrique L Staniak, Itamar de Souza Santos, Paulo Andrade Lotufo, Isabela M Bensenor
BACKGROUND: Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. OBJECTIVE: To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate...
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28143688/sleep-apnea-state-of-the-art
#17
REVIEW
Martin R Cowie
Many patient with, or at risk of, cardiovascular disease have sleep disordered breathing (SDB), which can be either obstructive (with intermittent collapse of the upper airway) or central (episodic loss of respiratory drive). SDB is associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in SDB have either been neutral (obstructive sleep apnea) or suggested the possibility of harm, likely from increased sudden death, in central sleep apnea...
December 20, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28132683/probability-of-accurate-heart-failure-diagnosis-and-the-implications-for-hospital-readmissions
#18
Sandra A Carey, Kyle Bass, Giovanna Saracino, Cara A East, Joost Felius, Paul A Grayburn, Ravi C Vallabhan, Shelley A Hall
Heart failure (HF) is a complex syndrome with inherent diagnostic challenges. We studied the scope of possibly inaccurately documented HF in a large health care system among patients assigned a primary diagnosis of HF at discharge. Through a retrospective record review and a classification schema developed from published guidelines, we assessed the probability of the documented HF diagnosis being accurate and determined factors associated with HF-related and non-HF-related hospital readmissions. An arbitration committee of 3 experts reviewed a subset of records to corroborate the results...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28126479/positive-airway-pressure-therapy-in-heart-failure-patients-long-term-effects-on-lung-function
#19
Henrik Fox, Susanne Witzel, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
PURPOSE: The prevalence of sleep-disordered breathing (SDB) in patients with heart failure (HF) is high. Positive airway pressure (PAP) is first-choice therapy, but recent data indicates that PAP therapy may increase mortality in HF patients with reduced ejection fraction (HF-REF) and predominant central sleep apnea (CSA). This study investigated long-term effects of PAP therapy on pulmonary function, including respiratory muscle strength. All patients underwent multichannel cardiorespiratory polysomnography (PSG) and comprehensive lung function testing at baseline and follow-up (mean 588±43days)...
January 23, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28124622/intermittent-hypoxia-causes-nox2-dependent-remodeling-of-atrial-connexins
#20
Joanna Gemel, Zihan Su, Alex Gileles-Hillel, Abdelnaby Khalyfa, David Gozal, Eric C Beyer
BACKGROUND: Obstructive sleep apnea has been linked to the development of heart disease and arrhythmias, including atrial fibrillation. Since altered conduction through gap junction channels can contribute to the pathogenesis of such arrhythmias, we examined the abundance and distributions of the major cardiac gap junction proteins, connexin40 (Cx40) and connexin43 (Cx43) in mice treated with sleep fragmentation or intermittent hypoxia (IH) as animal models of the components of obstructive sleep apnea...
January 17, 2017: BMC Cell Biology
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