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carotid body and OSA

Rebeca R Harmon, Jose Jayme G De Lima, Luciano F Drager, Natanael P Portilho, Valéria Costa-Hong, Luiz A Bortolotto, Geraldo Lorenzi-Filho, Maria Eugênia F Canziani
BACKGROUND: Obstructive sleep apnea (OSA) is common in hemodialysis (HD) patients. The reasons for the high prevalence and whether OSA is associated with vascular impairment, end-organ damage, and prognosis are not completely clear. METHODS: We evaluated patients with low cardiovascular risk on HD, not treated by CPAP. Laboratory tests, sleep questionnaires (Berlin and Epworth) and polysonography studies, echocardiography, and markers of arterial stiffness and atherosclerosis were performed...
December 24, 2017: Sleep & Breathing, Schlaf & Atmung
Rodrigo Iturriaga
The carotid body (CB) is considered the main O2 chemoreceptor, which contributes to the cardiorespiratory homeostasis and ventilatory acclimatization. In clinical medicine, the most common pathology associated with the CB are tumours. However, a growing body of evidences supports the novel idea that an enhanced CB chemosensory discharge contributes to the autonomic dysfunction and pathological consequences in obstructive sleep apnoea (OSA), hypertension, systolic heart failure (HF) and cardiometabolic diseases...
November 8, 2017: Journal of Physiology
Eduardo Borsini, Magalí Blanco, Martín Bosio, Marcela Schrappe, Glenda Ernst, Daniela Nosetto, Nazarena Gaggioli, Alejandro Salvado, Osvaldo Manuale, Miguel Schiavone
INTRODUCTION: To identify patients at risk for obstructive sleep apnea (OSA) syndrome at a specialized hypertension center, we administered questionnaires and used respiratory polygraphy (RP). RESULTS: We studied 168 patients (64.8% men and 35.2% women). Patients' body mass index (BMI) was 34.7 ± 6.79 and Epworth Sleepiness Scale (ESS) scores were 8.01 for male and 8.92 for women (p = 0.69). RP recordings revealed AHI (Apnea-Hypopnea Index) of 18.03 ± 15...
September 5, 2017: Clinical and Experimental Hypertension: CHE
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
Rodrigo Iturriaga, María Paz Oyarce, Ana Carolina Rodrigues Dias
Obstructive sleep apnea (OSA), a common breathing disorder, is recognized as an independent risk factor for systemic hypertension. Among the alterations induced by OSA, the chronic intermittent hypoxia (CIH) is considered the main factor for the hypertension. Exposure of rodents to CIH is the gold-standard method to study the mechanisms involved in the cardiovascular alterations induced by OSA. Although it is well known that CIH produces hypertension, the underlying mechanisms are not totally elucidated. It is likely that the CIH-induced systemic oxidative stress and inflammation may elicit endothelial dysfunction and increase the arterial blood pressure...
May 2017: Current Hypertension Reports
L-J Liao, T-Y Cho, T-W Huang
OBJECTIVE: This study compares the carotid intima-media thickness (CIMT) in different severity of obstructive sleep apnoea (OSA) patients and assesses the role of OSA in carotid artery vasculopathy with control of multiple co-morbidities. STUDY DESIGN: Prospective case-control study. SETTING: Tertiary referral centre. PARTICIPANTS: This study recruited 36 volunteers without the complaints of sleep-disordered breathing, 27 patients with mild-moderate OSA and 39 patients with severe OSA...
October 2017: Clinical Otolaryngology
Jayasri Nanduri, Ying-Jie Peng, Ning Wang, Shakil A Khan, Gregg L Semenza, Ganesh K Kumar, Nanduri R Prabhakar
KEY POINTS: The effects of short-term (ST; 10 days) and long-term (LT; 30 days) intermittent hypoxia (IH) on blood pressure (BP), breathing and carotid body (CB) chemosensory reflex were examined in adult rats. ST- and LT-IH treated rats exhibited hypertension, irregular breathing with apnoea and augmented the CB chemosensory reflex, with all these responses becoming normalized during recovery from ST- but not from LT-IH. The persistent cardiorespiratory responses to LT-IH were associated with elevated reactive oxygen species (ROS) levels in the CB and adrenal medulla, which were a result of DNA methylation-dependent suppression of genes encoding anti-oxidant enzymes (AOEs)...
January 1, 2017: Journal of Physiology
Guo-She Lee, Li-Ang Lee, Chao-Yung Wang, Ning-Hung Chen, Tuan-Jen Fang, Chung-Guei Huang, Wen-Nuan Cheng, Hsueh-Yu Li
Obstructive sleep apnea (OSA) is a known risk factor for atherosclerosis. We investigated the association of common carotid artery intima-media thickness (CCA-IMT) with snoring sounds in OSA patients. A total of 30 newly diagnosed OSA patients with no history of cardiovascular diseases were prospectively enrolled for measuring mean CCA-IMT with B-mode ultrasonography, body mass index, metabolic syndrome, 10-year cardiovascular disease risk score, high-sensitivity C-reactive protein, and homocysteine. Good-quality signals of full-night snoring sounds in an ordinary sleep condition obtained from 15 participants were further acoustically analyzed (Included group)...
2016: Scientific Reports
Harun Karamanli, Aysel Kiyici, Bilal Arik, Duran Efe, Recep Akgedik
Obstructive sleep apnea (OSA) is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (CIMT) is strongly associated with the presence of significant risk factors for cardiovascular disturbances. A disturbance in the oxidative/antioxidative balance is involved in the pathogenesis of OSA and cardiovascular diseases. Ischemia-modified albumin (IMA) is suggested as a novel marker of oxidative stress; IMA can be defined as decreased binding of transitional metal ions to serum albumin in oxidative status...
June 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Clare J Ray, Ben Dow, Prem Kumar, Andrew M Coney
Models of chronic intermittent hypoxia (CIH), the main feature of obstructive sleep apnoea (OSA), have demonstrated dysregulation of the cardiovascular and respiratory systems resulting in hypertension, cardiac hypertrophy and alterations in the hypoxic ventilatory response (HVR) due to changes in sympathetic and respiratory control by the carotid body. In the UK, treatment of OSA is only offered to patients with an apnoea-hypopnoea index (AHI) >15, we investigated whether mild CIH produced significant pathophysiological changes, which might inform treatment guidelines...
2015: Advances in Experimental Medicine and Biology
Eftal Murat Bakırcı, Edhem Ünver, Hüsnü Değirmenci, Tülay Kıvanç, Murat Günay, Hikmet Hamur, Mutlu Büyüklü, Gökhan Ceyhun, Ergun Topal, Taha Abdulkadir Çoban
OBJECTIVE: The inflammatory process plays an important role in the development of cardiovascular complications in patients with obstructive sleep apnea syndrome (OSAS). YKL-40/chitinase 3-like protein 1 is a novel biomarker of systemic inflammation. This study aimed to investigate whether carotid intima-media thickness (CIMT), a useful marker for early atherosclerosis, is associated with serum YKL-40/chitinase 3-like protein 1 levels in patients with normotensive and nondiabetic OSAS...
June 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Gregg L Semenza, Nanduri R Prabhakar
Obstructive sleep apnea (OSA) is one of the most common causes of hypertension in western societies. OSA causes chronic intermittent hypoxia (CIH) in specialized O2-sensing glomus cells of the carotid body. CIH generates increased reactive oxygen species (ROS) that trigger a feedforward mechanism in which increased intracellular calcium levels ([Ca(2+)]i) trigger increased HIF-1α synthesis and increased HIF-2α degradation. As a result, the normal homeostatic balance between HIF-1α-dependent prooxidant and HIF-2α-dependent antioxidant enzymes is disrupted, leading to further increases in ROS...
November 15, 2015: Journal of Applied Physiology
D Koren, J A Chirinos, L E L Katz, E R Mohler, P R Gallagher, G F Mitchell, C L Marcus
BACKGROUND/OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) may be a cardiovascular disease (CVD) risk factor independently of obesity in adults. Pediatric studies have associated OSAS with endothelial dysfunction, but few studies have examined relationships between OSAS and macrovascular sequelae. Our objective was to examine OSAS's independent contribution to macrovascular CVD risk measures in obese adolescents. SUBJECTS/METHODS: This cross-sectional observational study was conducted at Children's Hospital of Philadelphia Clinical Research and Academic Sleep Centers, and University of Pennsylvania Vascular Research Unit...
July 2015: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Rodrigo Iturriaga, David C Andrade, Rodrigo Del Rio
The carotid body (CB) plays a main role in the maintenance of the oxygen homeostasis. The hypoxic stimulation of the CB increases the chemosensory discharge, which in turn elicits reflex sympathetic, cardiovascular, and ventilatory adjustments. An exacerbate carotid chemosensory activity has been associated with human sympathetic-mediated diseases such as hypertension, insulin resistance, heart failure, and obstructive sleep apnea (OSA). Indeed, the CB chemosensory discharge becomes tonically hypereactive in experimental models of OSA and heart failure...
2014: Frontiers in Physiology
Sílvia V Conde, Joana F Sacramento, Maria P Guarino, Constancio Gonzalez, Ana Obeso, Lucilia N Diogo, Emilia C Monteiro, Maria J Ribeiro
The carotid bodies (CB) are peripheral chemoreceptors that sense changes in arterial blood O2, CO2, and pH levels. Hypoxia, hypercapnia, and acidosis activate the CB, which respond by increasing the action potential frequency in their sensory nerve, the carotid sinus nerve (CSN). CSN activity is integrated in the brain stem to induce a panoply of cardiorespiratory reflexes aimed, primarily, to normalize the altered blood gases, via hyperventilation, and to regulate blood pressure and cardiac performance, via sympathetic nervous system (SNS) activation...
2014: Frontiers in Physiology
Hulya Gunbatar, Bunyamin Sertogullarindan, Selami Ekin, Serkan Akdag, Ahmet Arisoy, Havva Sayhan
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive collapse of the upper airway during sleep. Red blood cell distribution width (RDW) increases platelet activation and has been reported as an independent predictor of adverse outcomes in the general population and is believed to be associated with cardiovascular morbidity and mortality. We evaluated RDW, mean platelet volume (MPV), and platelet distribution width (PDW) as a severity index in OSAS and the relationship between carotid intima media thickness and pulmonary hypertension...
2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
M Kostrzewska, T Piorunek, K Hoffmann, H Batura-Gabryel, S Cofta
In this study we determined the relationship between the severity of obstructive sleep apnea (OSA) and body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), and carotid intima-media thickness (cIMT) in 30 hypertensive male patients, aged 30-70, with newly diagnosed OSA (15 with moderate OSA - Group A, and 15 with severe OSA - Group B) and 20 non-OSA hypertensive individuals (Group C). We revealed significant differences in cIMT between Groups B and C (0.9 ± 0.3 vs. 0.6 ± 0.1 mm and 1.0 ± 0...
2015: Advances in Experimental Medicine and Biology
Lucilia N Diogo, Emília C Monteiro
Sleep apnea/hypopnea disorders include centrally originated diseases and obstructive sleep apnea (OSA). This last condition is renowned as a frequent secondary cause of hypertension (HT). The mechanisms involved in the pathogenesis of HT can be summarized in relation to two main pathways: sympathetic nervous system stimulation mediated mainly by activation of carotid body (CB) chemoreflexes and/or asphyxia, and, by no means the least important, the systemic effects of chronic intermittent hypoxia (CIH). The use of animal models has revealed that CIH is the critical stimulus underlying sympathetic activity and hypertension, and that this effect requires the presence of functional arterial chemoreceptors, which are hyperactive in CIH...
2014: Frontiers in Physiology
Elena Olea, Maria Teresa Agapito, Teresa Gallego-Martin, Asuncion Rocher, Angela Gomez-Niño, Ana Obeso, Constancio Gonzalez, Sara Yubero
Obstructive sleep apnea (OSA) consists of sleep-related repetitive obstructions of upper airways that generate episodes of recurrent or intermittent hypoxia (IH). OSA commonly generates cardiovascular and metabolic pathologies defining the obstructive sleep apnea syndrome (OSAS). Literature usually links OSA-associated pathologies to IH episodes that would cause an oxidative status and a carotid body-mediated sympathetic hyperactivity. Because cardiovascular and metabolic pathologies in obese patients and those with OSAS are analogous, we used models (24-wk-old Wistar rats) of IH (applied from weeks 22 to 24) and diet-induced obesity (O; animals fed a high-fat diet from weeks 12 to 24) to define the effect of each individual maneuver and their combination on the oxidative status and sympathetic tone of animals, and to quantify cardiovascular and metabolic parameters and their deviation from normality...
October 1, 2014: Journal of Applied Physiology
François Abboud, Ravinder Kumar
Nearly two decades ago, we evaluated ten patients with obstructive sleep apnea (OSA). We determined that alarming nocturnal oscillations in arterial pressure and sympathetic nerve activity (SNA) were caused by regulatory coupling and neural interactions among SNA, apnea, and ventilation. Patients with OSA exhibited high levels of SNA when awake, during normal ventilation, and during normoxia, which contributed to hypertension and organ damage. Additionally, we achieved a beneficial and potentially lifesaving reduction in SNA through the application of continuous positive airway pressure (CPAP), which remains a primary therapeutic approach for patients with OSA...
April 2014: Journal of Clinical Investigation
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