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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obstructive sleep apnea syndrome has been linked to cardiovascular complications. The diagnosis of effects of sleep apnea on heart may be difficult before apparent examination findings. The aim of the present study was to evaluate changes of myocardial contractile properties in patients affected by sleep apnea showing tissue Doppler imaging, in the face of quite normal myocardial contractility on standard echocardiography. Shortly, tissue Doppler imaging may represent an early stage of myocardial abnormality despite a preserved global function.
Int J Cardiol 2007 May 31
PMID:Occult cardiac dysfunction in patients with obstructive sleep apnea syndrome revealed by tissue Doppler imaging. 1699 99

Heart failure (HF) and sleep-disordered breathing are conditions highly prevalent in the general population that often co-exist in the same patient. Epidemiological and pathophysiological studies indicate that there may be a causal link between sleep-disordered breathing and HF with either left ventricular systolic dysfunction or preserved ejection fraction. The presence of sleep-disordered breathing in HF patients expose the cardiovascular system to intermittent hypoxia, sympathetic activation, and increased preload and afterload and they trigger several inflammatory, oxidative and neurohumoral mechanisms that may precipitate the progression of the disease. Although there are no available data to indicate that treating sleep-disordered breathing in HF patients reduce cardiac mortality, several studies demonstrate a significant improvement in structural and functional cardiovascular parameters. This review focuses on the clinical and epidemiological bases, the pathophysiological mechanisms and the therapeutic implications between HF and sleep apnea-hypopnea syndromes.
Rev Esp Cardiol 2007 Apr
PMID:[Sleep apnea-hypopnea syndromes and heart failure]. 1752 50

Sleep apnoea syndrome is frequent in patients with heart failure and associated with a worse prognosis. We evaluated a new device (Auricall) for non-invasive, continuous recording of oxygen saturation (SpO(2)) and heart rate (HR) in patients with heart failure. We studied 20 patients (mean age 48.43+/-14.4 years, NYHA class II-III). All patients were requested to carry the device for at least 36 h and to write a diary during the recording time. Satisfactory recording of SpO(2) and HR was possible to obtain in 18 of 20 patients. Indeed 9 out of 18 patients showed significant periodic changes in SpO(2) during sleep. Therefore, Auricall is a useful tool to non-invasively monitor SpO(2) and HR in patients with heart failure and to detect breathing disorders in these patients.
Int J Cardiol 2008 Sep 16
PMID:Auricall. A new device for a non-invasive, wireless, continuous monitoring of oxygen saturation and heart rate in patients with heart failure. 1772 Feb 64

Obesity is associated with an increased risk of development of chronic heart failure, but recent epidemiological studies indicate that a higher body mass index (BMI) is associated with a better survival rate. This is described as the 'obesity paradox' or 'reverse epidemiology'. A 42-year-old male was admitted because of recurrent episodes of decompensated heart failure, and the diagnosis was idiopathic dilated cardiomyopathy complicated with severe obesity (BMI 46.0), nonsustained ventricular tachycardia, and central type sleep apnea syndrome. Combined therapy with weight loss (BMI 46.0 to 30.8) and amiodarone (200 mg/day) was instituted in addition to the previous regimen including angiotensin converting enzyme inhibitor, beta blocker, diuretics and pimobendan, improved cardiac function, exercise tolerance, and cardiac sympathetic nerve activity evaluated by cardiac 123I-metaiodobenzylguanidine scintigraphy. Furthermore, we succeeded in uptitration of carvedilol(5 to 10mg/day). This case highlights the possible beneficial effect of weight loss in patients with chronic heart failure complicated with obesity, and the resultant improvement of cardiac sympathetic nerve activity suggests that weight loss may partially mimic beta blocker effects in patients with systolic heart failure.
J Cardiol 2007 Aug
PMID:[Combined therapy with weight loss and amiodarone improved cardiac function in a patient with idiopathic dilated cardiomyopathy complicated with severe obesity: a case report]. 1780 98

The prevalence and characteristics of sleep-disordered breathing (SDB) in patients with ventricular arrhythmias, such as premature ventricular complexes and ventricular tachycardia, are unknown. Therefore, this study was conducted to evaluate the prevalence of SDB in patients with severe ventricular arrhythmias and normal left ventricular (LV) function. Thirty-five patients (63% men, mean age 57.4 +/- 13.8 years) underwent a sleep study. All patients had ventricular tachycardia or frequent premature ventricular complexes (>or=300/hour) and had been referred to the cardiology department for medication, catheter ablation therapy, or the implantation of a cardioverter-defibrillator. Patients with heart failure with LV ejection fractions <50% were excluded; in the remaining patients, the mean LV ejection fraction was 63.9 +/- 8.0%. Twenty-one patients (60%) had SDB with apnea-hypopnea indexes >or=5/hour, and the average apnea-hypopnea index was 22.7 +/- 17.9/hour. Twelve patients (34%) had moderate to severe SDB, with an average apnea-hypopnea index of 33.6 +/- 16.6/hour. Central dominant sleep apnea was evident in 3 patients with SDB. The average age and body mass index were significantly higher in patients with SDB than in those without SDB (age 62.0 +/- 12.8 vs 50.6 +/- 12.7 years, body mass index 26.3 +/- 4.0 vs 21.2 +/- 2.0 kg/m2). In conclusion, this study found a high prevalence of SDB in patients with ventricular arrhythmias and normal LV function.
Am J Cardiol 2008 Mar 15
PMID:Association of sleep-disordered breathing and ventricular arrhythmias in patients without heart failure. 1832 58

This review summarizes recent scientific developments in ambulatory monitoring and its legal implications in appropriately selected patients. It also considers how new cardiac pacing devices can be used in the clinical monitoring of atrial fibrillation, sleep apnea and, in transplant patients, heart failure and transplant rejection. In addition, the system of accreditation for cardiac pacing services in Spain is outlined, with a focus on process development and quality indicators. Finally, the scientific articles on cardiac pacing that made the greatest impact in 2007 are summarized.
Rev Esp Cardiol 2008 Feb
PMID:[Progress in cardiac pacing]. 1834 41

Bradyarrhythmias (BA) have been reported in patients with sleep apnea (SA), but the incidence of SA in patients with BA remains unclear. A case-control study was conducted to assess the prevalence of high-risk features of SA in patients with documented BA on 24-hour Holter monitoring compared with patients without BA. Controls were age-matched patients selected from those with no evidence of BA on 24-hour Holter monitoring. BA were defined as the presence of pauses of >3 seconds, regardless of the mechanism, and/or heart rate <40 beats/min during presumed waking hours (8 a.m. to 8 p.m.). High-risk features of SA were determined by the Berlin Questionnaire, with positive results defined as having '2 of 3 positive high-risk categories. Body mass index (BMI), hypertension, beta-blocker use, and other underlying characteristics were cataloged. Nineteen patients with documented BA and 47 with no BA were identified. The mean ages and BMIs in the active and control groups were not statistically significant. High-risk features for SA were present in 57.8% of patients in the BA group compared with 21.3% in the control group (p = 0.003). After controlling for age, BMI, hypertension, and beta-blocker use, patients with BA were 6 times more likely to have high-risk features of SA compared with those without BA (logistic regression odds ratio 6.1, 95% confidence interval 1.5 to 24, p = 0.012). In conclusion, irrespective of BMI, age, and other underlying risk factors, the presence of daytime BA was highly associated with high-risk features of SA.
Am J Cardiol 2008 Apr 15
PMID:Relation of daytime bradyarrhythmias with high risk features of sleep apnea. 1839 49

There is a strong prevalence of sleep apnoea syndrome in general population. Cardiac arrhythmia and conduction disturbances during sleep may complicate this syndrome. We report the case of a 73-year-old patient to whom the sleep apnoea syndrome was diagnosed after varied heart blocks during the sleep. A treatment by continuous positive airway pressure (CPAP) permitted to correct these conduction disturbances and to avoid pacemaker implantation.
Ann Cardiol Angeiol (Paris) 2009 Apr
PMID:[Night cardiac rhythm and conduction disturbances revealing obstructive sleep apnoea syndrome]. 1857 13

Sleep apnea (SA) is more prevalent in patients with atrial fibrillation (AF), but the impact of cardioversion on disordered breathing is unknown. Thus, we investigated the influence of restoring sinus rhythm in patients with AF and atrial flutter (AFlut) on SA. The 16 patients (mean age 63.1 +/- 11.2) with AF (n = 6) or AFlut (n = 10) and SA (apnea-hypopnea index >10) received cardioversion or ablation of cavotricuspid isthmus. We compared the severity of SA by sleep polygraphy under AF/Aflut with the first night after restoring sinus rhythm and after 4 weeks. Apnea-hypopnea index before and immediately after restoring sinus rhythm was similar (31.7 +/- 13.2 vs 30.1 +/- 15.7, p = NS) despite a significantly reduced heart rate (86.7 +/- 26.5 vs 67.8 +/- 11.9 beats/min, p <0.02). After 4 weeks, apnea-hypopnea index remained unchanged (38.1 +/- 18.1, p = NS) although heart rate was further reduced (61.8 +/- 8.8 beats/min, p <0.003). In our study, SA could not be improved by cardioversion of AF/AFlut. Therefore, although it is well known that SA leads to AF, eliminating AF does not cure or improve SA. In conclusion, our study shows that AF should be regarded more as an innocent bystander than a causative or aggravating condition in SA.
Am J Cardiol 2008 Sep 15
PMID:Effect of restoring sinus rhythm on sleep apnea in patients with atrial fibrillation or flutter. 1877 93

Obesity has reached epidemic proportions in much of the industrialized world, and is also increasing in prevalence in the developing world. In the later decades of the 20th century until present, there have been numerous epidemiological studies reporting the relationship between excess weight and total, or all-cause, mortality. Obesity is associated with a wide variety of comorbidities such as type 2 diabetes, systemic hypertension, cardiovascular disease, certain cancers and sleep apnea, most of which may lead to disability or death. In general, the risk of developing comorbidities such as diabetes and cardiovascular disease rises as body mass index (BMI) increases. Using BMI, an indicator of relative weight for height (kg/m(2)) and a frequently used surrogate for assessing excess body fat, epidemiological studies have found linear, U- or J-shaped relationships between total mortality and BMI. However, obesity is remarkably heterogeneous. Obese patients considered to be 'at risk' are mostly characterized by features associated with the metabolic syndrome. The aim of the present paper is to review the cardiovascular consequences of obesity and to review some of the literature emphasizing why the cardiologist should measure other indices of adiposity in order to refine clinical assessment of obese individuals.
Can J Cardiol 2008 Sep
PMID:Targeting abdominal obesity in cardiology: can we be effective? 1878 31


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