Does Treating Sleep Apnea Reduce Heart Failure Risks?
Abstract Sleep-disordered breathing (SDB) is the most common comorbidity in heart failure (HF) patients. SDB, including both central sleep apnea (CSA) and obstructive sleep apnea (OSA), affects up to 70 % of all heart patients. Numerous studies have identified intermittent hypoxia, oxidative stress, and sympathetic activation as the main pathways through which SDB exerts its negative cardiovascular consequences. The etiological relation between SDB and HF is complex and multi-layered. On one level, SDB contributes to the progression of cardiovascular disease (CVD) into HF; on another level, SDB is a consequence of severe advanced HF. At all stages of CVD, SDB likely contributes to the acceleration of disease progression into end-stage process including advanced HF, stroke, and death. Figure 1 describes the role of OSA in the progression of CVD risk status, the role of CSA in end-stage CVD (including HF) and the reciprocal relationship between advanced CVD and SDB. Current evidence supports that SDB treatment improves several physiological parameters and disease markers in patients with CVD and likely decreases the progression into HF. In patients with established HF, available evidence supports that untreated SDB is independently associated with negative consequences in heart failure. However, there are insufficient studies in support of a conclusion that treatment of SDB changes important HF outcomes. In particular, there are no adequately powered randomized c...
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Authors: Tzikas S, Papadopoulos C, Evangeliou AP, Vassilikos V PMID: 32470561 [PubMed - as supplied by publisher]
CONCLUSIONS: Further studies are required in order to establish the complicated association between SARS-CoV-2 infection and its effects on the cardiovascular system. Our knowledge regarding diagnostic approaches, therapeutic management and preventive measures is constantly enriched throughout an abundance of ongoing research in the respective fields. PMID: 32472990 [PubMed - as supplied by publisher]
Obstructive sleep apnea (OSA) is present in up to 25% of otherwise healthy individuals. OSA is associated with intermittent hypoxia, oxidative stress, sympathetic activation, and an inflammatory response. These perturbations mediate the role of OSA as an independent and modifiable risk factor for cardiovascular disease (CVD). OSA can induce CVD or accelerate the progression of CVD into an end-stage disorder, including heart failure and stroke. Current clinical recommendations are based on existing clinical trial data and the clinical experience of our program; current and future clinical trials will help to optimize manage...