Biomarkers in patients with heart failure and central sleep apnoea: findings from the SERVE ‐HF trial

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 patients' ris k, and this is the first study applying a large set of circulating biomarkers in patients with both HFrEF and CSA.Methods and resultsCirculating protein ‐biomarkers (n = 276) ontologically involved in CV pathways, were studied in 749 (57% of the trial population) patients (biomarker substudy), to investigate their association with the study outcomes (primary outcome, CV death and all‐cause death). The mean age was 69 ± 10 years, and >  90% were male. The groups (ASV vs. control and biomarker substudy vs. no biomarker) were well balanced. The “best” clinical prognostic model included male sex, systolic blood pressure 
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research

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We examined a subgroup of 1,369 patients from the Japan Morning Surge Home Blood Pressure study; these were patients who had cardiovascular risk factors and had undergone ambulatory blood pressure (BP) monitoring. HR non-dipping status was defined as (awake HR - sleep HR)/awake HR
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens 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
Conclusions: In atrial myocardium of SDB patients, increased CaMKII-dependent phosphorylation of NaV1.5 results in dysregulation of INa with pro-arrhythmic activity that was independent from pre-existing co-morbidities. Inhibition of CaMKII may be useful for prevention or treatment of arrhythmias in SDB. PMID: 31902278 [PubMed - as supplied by publisher]
Source: Circulation Research - Category: Cardiology Authors: Tags: Circ Res Source Type: research
Publication date: Available online 24 December 2019Source: Heart &LungAuthor(s): Sikandar H Khan, Shalini Manchanda, Ninotchka L Sigua, Erika Green, Philani B Mpofu, Siu Hui, Babar A. KhanAbstractBackgroundIn-hospital respiratory outcomes of non-surgical patients with undiagnosed obstructive sleep apnea (OSA), particularly those with significant comorbidities are not well defined. Undiagnosed and untreated OSA may be associated with increased cardiopulmonary morbidity.Study objectivesEvaluate respiratory failure outcomes in patients identified as at-risk for OSA by the Berlin Questionnaire (BQ).MethodsThis was a retros...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
AbstractHeart failure with reduced ejection fraction (HFrEF) is common in patients with adult congenital heart disease. Many of the most common congenital defects have a high prevalence of HFrEF, including left-sided obstructive lesions (aortic stenosis, coarctation of the aorta, Shone complex), tetralogy of Fallot, Ebstein anomaly, lesions in which there is a systemic right ventricle, and lesions palliated with a Fontan circulation. However, heart failure with preserved ejection fraction (HFpEF) is also prevalent in all these lesions. Comprehensive evaluation includes physical exam, biomarkers, echocardiography and advanc...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
CONCLUSION: 'AVNRT of the sick' has not been previously described in the medical literature, to our knowledge. It can be successfully treated with medications and the chance of recurrence after resolution of the acute illness is small. PMID: 31802764 [PubMed - in process]
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars Source Type: research
Authors: Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S Abstract Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overv...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
Objectives: To assess the particularities of patients with obstructive sleep apnea syndrome (OSAS) and heart failure (HF) focusing in the latest guideline recommendation of mid-range ejection fraction (HFmrEF) and comparing with reduced EF (HFrEF) and preserved EF (HFpEF).Methods: A number of 143 older patients with OSAS and HF were evaluated in 3 sleep labs of Victor Babes Hospital and Cardiovascular Institute, Timisoara, Western Romania. We collected general data, sleep questionnaires, anthropometric, comorbidities, lab test results and performed polysomnography and echocardiographic measurements.Results: Patients were d...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Introduction: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary (COPD), are usually accompanied by several comorbidities. Aim of the study was to assess the prevalence of comorbidities in OSA and COPD-OSA overlap syndrome (OS) patients and to explore differences between these two groups.Methods: Included were consecutive OS (n=163, 138 males, AHI>5/h and FEV1/FVC5/h and FEV1/FVC>0.7), matched in terms of gender, age, BMI, and smoking history, diagnosed with polysomnography and pulmonary function testing.Results: As mentioned, the two groups were matched in age (p=0.221), BMI (p=0.496) and neck circumfer...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Aims: To collect real life clinical data and long-term follow-up of all CHF patients grade of severity (reduced (HFrEF), mid-range (HFmrEF) or preserved ejection fraction (HFpEF)) with SDB requesting ASV.Methods: Medical history, medications, clinical presentation, sleep study, cardiac function and quality of life were assessed at inclusion. Patients are followed up to 2 years. Inclusion data are presented in median with interquartile range or in % of the sample.Results: 509 CHF pts were included, 72 [64; 79] year old, men (88%) and with a BMI of 28 [25; 32] kg/m². Patients were HFrEF, HFmrEF and HFpEF, in 31, 20, and...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
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