Randomized controlled trial of an oral appliance (SomnoDent) for sleep ‐disordered breathing and cardiac function in patients with heart failure

Clinical Cardiology, EarlyView.
Source: Clinical Cardiology - Category: Cardiology Authors: Source Type: research

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Journal of Clinical Sleep Medicine, Ahead of Print.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Authors: Source Type: research
AbstractObstructive sleep apnea (OSA) syndrome is the most common sleep-breathing disorder, which is associated with increase cardiovascular morbidity and mortality. OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and stroke. Studies showed the significant relationship between OSA and cardiac remodeling. The majority of investigations were focused on the left ventricle and its hypertrophy and function. Fewer studies investigated right ventricular structure and function revealing deteriorated diastolic and systolic function. Data regarding left and right...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
In acute myocardial infarction (AMI), impaired myocardial salvage and large infarct size result in residual heart failure, which is one of the most important predictors of morbidity and mortality after AMI. Sl...
Source: Trials - Category: General Medicine Authors: Tags: Study protocol Source Type: research
ConclusionsVarying definitions of HFpEF used in studies are a substantial limitation in interpretation of findings. The reduced efficacy noted in contemporary HF DMP studies may not only be due to improvements in usual care but may also reflect inclusion of heterogeneous patients with HFpEF or HF with mid ‐range EF who may not respond in the same way as HFrEF to individual components. Given that patients with HFpEF are older and multi‐morbid, DMPs targeting HFpEF should not rely on a single‐disease focus but provide care that addresses predisposing and presentation phenotypes and draws on the p rinciples of comprehen...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
We examined the relationships between FMD and SDB-related parameters, including our original index of accumulated hypoxemia by SDB throughout one-nigh t sleep: the time desaturation summation index (TDS), calculated as follows: (100% − averaged arterial oxygen saturation during sleep) × total sleep time. The mean age in the CHF and non-CHF groups was 59.0 ± 13.5 and 57.7 ± 11.4 years, respectively. Although the FMD in the 2 g roups were not significantly different, well-known adverse factors for FMD such as serum lipid profiles, blood pr...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Abstract Central sleep apnea/Hunter-Cheyne-Stokes Breathing (CSA/HCSB), is prevalent in patients with heart failure with reduced ejection fraction (HFrEF). The acute pathobiological consequences of CSA/HSCB eventually lead to sustained sympathetic over-activity, repeated hospitalization, and premature mortality. Few small randomized controlled trials (RCTs) have shown statistically significant and clinically important reduction in sympathetic activity when CSA/HCSB is attenuated by oxygen or positive airway pressure (PAP) therapy, both continuous PAP (CPAP) and Adaptive servo ventilation (ASV) devices. Yet, the tw...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
AbstractAimsThe Treatment of Sleep ‐Disordered Breathing with Predominant Central Sleep Apnoea by Adaptive Servo Ventilation in Patients with Heart Failure trial investigated the effects of adaptive servo‐ventilation (ASV) (vs. control) on outcomes of 1325 patients with heart failure and reduced ejection fraction (HFrEF) and cent ral sleep apnoea (CSA). The primary outcome (a composite of all‐cause death or unplanned HF hospitalization) did not differ between the two groups. However, all‐cause and cardiovascular (CV) mortality were higher in the ASV group. Circulating biomarkers may help in better ascertain patient...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Conclusion: Chronic SF mimicking OSA did not induce echocardiographic changes in cardiac structure and function in both healthy and HF mice. Thus, the deleterious cardiac consequences of OSA are likely induced by other perturbations associated with this prevalent condition, or result from interactions with underlying comorbidities in OSA patients.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionAs expected, OSA is frequent in coronary artery disease patients (early after ACS in this study). High prevalence of CSA was less expected. Our results suggest that, before looking for another (neurological) cause, confirmation of CSA should be done at least 2 months after the ACS.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
ConclusionAmong patients with AF, OSA is an independent risk factor for MACNE and, more specifically, stroke/SE.Graphical Abstract
Source: American Heart Journal - Category: Cardiology Source Type: research
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