scholarly journals Association between sleep-disordered breathing and arterial stiffness in heart failure patients with reduced or preserved ejection fraction

2018 ◽  
Vol 5 (3) ◽  
pp. 284-291 ◽  
Author(s):  
Satoshi Suzuki ◽  
Akiomi Yoshihisa ◽  
Yu Sato ◽  
Shunsuke Watanabe ◽  
Tetsuro Yokokawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Stiffness ◽  
Ejection Fraction ◽  
Sleep Disordered Breathing ◽  
Preserved Ejection Fraction ◽  
Heart Failure Patients ◽  
Disordered Breathing

scholarly journals Profile of sleep disordered breathing in heart failure with preserved ejection fraction

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Nitesh Gupta ◽  
Sumita Agrawal ◽  
Akhil D. Goel ◽  
Pranav Ish ◽  
Shibdas Chakrabarti ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Sleep Disordered Breathing ◽  
Control Group ◽  
Preserved Ejection Fraction ◽  
Control Subjects ◽  
Obstructive Sleep ◽  
Disordered Breathing

Heart failure (HF) with preserved ejection fraction (HFpEF) represents nearly half of HF cases and is increasingly being recognized as a cause of morbidity and mortality. Hypertension (essential or secondary) is an important risk factor of HFpEF, owing to permanent structural changes in heart. A common cause of secondary hypertension is obstructive sleep apnea (OSA). In the present study, we have attempted to seek the frequency and characteristics of sleep disordered breathing (SDB) in HFpEF. Also, we tried to investigate if any correlation exists between the severity of SDB and the severity of diastolic dysfunction. This was a prospective, cross-sectional, case-control study in which 25 case patients with HFpEF and 25 control subjects were included. All the case patients and control subjects went through a detailed clinical, biochemical, echocardiography evaluation and overnight polysomnography. SDB was seen in 64% of the case patients having HFpEF and in 12% of control group with [odds ratio (OR)= 12.2, 95% confidence interval (CI) = 2.83-52.74; p<0.001]. A significant correlation of apnea-hypopnea index (AHI) severity was observed with degree of diastolic dysfunction (r = 0.67; p<0.001). Among HFpEF patients with SDB (16/25), 13 had OSA and only 3 had central sleep apnea (CSA). CSA was present in patients with severe diastolic dysfunction. There were no clinical or sleep quality differences among the OSA and the CSA group. To conclude, a higher frequency of SDB is observed in HFpEF patients. AHI severity correlates with degree of diastolic dysfunction. The underlying mechanisms of correlation between SDB and diastolic dysfunction either through uncontrolled hypertension or direct causation warrant further evaluation. 

Sleepiness and activity in heart failure patients with reduced ejection fraction and central sleep-disordered breathing

2017 ◽  
Vol 34 ◽  
pp. 217-223 ◽  
Author(s):  
Angela Atalla ◽  
Thomas W. Carlisle ◽  
Anita K. Simonds ◽  
Martin R. Cowie ◽  
Mary J. Morrell
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Sleep Disordered Breathing ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Disordered Breathing

scholarly journals Female Patients With Sleep-Disordered Breathing Display More Frequently Heart Failure With Preserved Ejection Fraction

2021 ◽  
Vol 8 ◽  
Author(s):  
Simon Lebek ◽  
Philipp Hegner ◽  
Maria Tafelmeier ◽  
Leopold Rupprecht ◽  
Christof Schmid ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Oxygen Saturation ◽  
Diastolic Dysfunction ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Right Atrial ◽  
Preserved Ejection Fraction ◽  
Female Patients ◽  
Disordered Breathing

Objective: Sleep-disordered breathing (SDB) is a widespread disease that is often associated with heart failure (HF) with preserved ejection fraction (HFpEF). HFpEF is more frequent in women than in men, but detailed pathomechanisms remain unclear. We investigated HFpEF in women and men in a high-risk cohort with SDB monitoring.Methods and Results: Three hundred twenty-seven patients (84.4% men) undergoing elective coronary artery bypass grafting were prospectively subjected to SDB monitoring, and an apnea–hypopnea index (AHI) ≥15/h defined SDB. HF was classified according to current guidelines. HFpEF was significantly more frequent in SDB patients compared to those without SDB (28 vs. 17%, P = 0.016). This distribution was driven by an increased frequency of HFpEF in female SDB patients (48% vs. only 25% in male, P = 0.022). In accordance, female patients with SDB exhibited significantly more impaired diastolic left ventricular filling compared to men (echocardiographic E/e′). In contrast to men, in women, minimum oxygen saturation (O2min, measured by polygraphy, R2 = 0.470, P &lt; 0.001) and time of oxygen saturation &lt;90% (R2 = 0.165, P = 0.044) were significantly correlated with E/e′. Moreover, the correlation between O2min and E/e′ was significantly different in women compared to men (P &lt; 0.001). Intriguingly, this association remained independent of clinical covariates in women [age, body mass index, systolic contractile dysfunction, diabetes mellitus, and glomerular filtration rate (GFR), R2 = 0.534, P = 0.042, multivariate regression analysis]. Since angiotensin II signaling has been mechanistically linked to HF, we measured protein expression of its cleavage enzyme ACE2 in human right atrial appendage biopsies (Western blot). Intriguingly, we found a significantly decreased ACE2 expression preferentially in women with SDB (2.66 ± 0.42 vs. 4.01 ± 2.47 in men with SDB, P = 0.005). In accordance, left ventricular mass index was significantly increased in women with SDB compared to women without SDB.Conclusion: In patients with SDB, HFpEF and diastolic dysfunction were more frequent in women compared to men. In contrast to men, the severity of SDB was associated with the degree of diastolic dysfunction in women. These insights might help to find sex-specific therapies for patients with sleep-disordered breathing and heart failure.Clinical Trial Registration: Unique identifier: NCT02877745, URL: http://www.clinicaltrials.gov.

Sleep Disordered Breathing in Heart Failure with Preserved Ejection Fraction

2013 ◽  
Vol 19 (8) ◽  
pp. S79-S80
Author(s):  
Kamal O. Shemisa ◽  
Claire Sullivan ◽  
Anupam Basuray ◽  
Neal Sawlani ◽  
Reena Mehra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Sleep Disordered Breathing ◽  
Preserved Ejection Fraction ◽  
Disordered Breathing
Sign in / Sign up

Export Citation Format

Share Document