Sleep disordered breathing in patients with heart failure

Sleep disordered breathing (SDB) is a common co-morbidity in patients with heart failure(HF). Both its forms — central and obstructive sleep apnea — are highly prevalent in thispopulation. SDB fragments sleep, impairs life quality, worsens exercise tolerance, worsens HFand is an independent predictor of poor prognosis. Still, SDB remains largely undiagnosed.Therefore, early detection of SDB seems to be of primary importance, especially in the presenceof new diagnostic and therapeutic methods. Treatment with continuous positive airwaypressure (CPAP) increases left ventricular ejection fraction and stroke volume in virtually allHF patients with obstructive and in 50% with central sleep apnea. For those in whom centralsleep apnea is not suppressed by CPAP, a trial of adaptive servoventilation is recommended.Although no randomized, controlled trials have shown improvement in mortality, several observationalstudies have shown that effective treatment of both forms of sleep apnea with variouspositive airway pressure devices improves survival of HF patients. Currently, 2 large trials withnewer masked based therapies with adaptive servoventilation are in progress. This article isa brief overview of present knowledge, the pathophysiology, diagnostic approach and therapy ofSDB

Risk factors associated with pulmonary hypertension in obesity hypoventilation syndrome

Pulmonary hypertension (PH) is prevalent in obesity hypoventilation syndrome (OHS). However, there is a paucity of data assessing pathogenic factors associated with PH. Our objective is to assess risk factors that may be involved in the pathogenesis of PH in untreated OHS.Peer reviewe

Obstructive Sleep Apnea in Heart Failure: Current Knowledge and Future Directions

Obstructive sleep apnea (OSA) is highly prevalent among patients with asymptomatic left ventricular systolic and diastolic dysfunction and congestive heart failure, and if untreated may contribute to the clinical progression of heart failure (HF). Given the health and economic burden of HF, identifying potential modifiable risk factors such as OSA and whether appropriate treatment improves outcomes is of critical importance. Identifying the subgroups of patients with OSA and HF who would benefit most from OSA treatment is another important point. This focused review surveys current knowledge of OSA and HF in order to provide: (1) a better understanding of the pathophysiologic mechanisms that may increase morbidity among individuals with HF and comorbid OSA, (2) a summary of current observational data and small randomized trials, (3) an understanding of the limitations of current larger randomized controlled trials, and (4) future needs to more accurately determine the efficacy of OSA treatment among individuals with HF

Obstructive Sleep Apnea in Heart Failure: Current Knowledge and Future Directions

Obstructive sleep apnea (OSA) is highly prevalent among patients with asymptomatic left ventricular systolic and diastolic dysfunction and congestive heart failure, and if untreated may contribute to the clinical progression of heart failure (HF). Given the health and economic burden of HF, identifying potential modifiable risk factors such as OSA and whether appropriate treatment improves outcomes is of critical importance. Identifying the subgroups of patients with OSA and HF who would benefit most from OSA treatment is another important point. This focused review surveys current knowledge of OSA and HF in order to provide: (1) a better understanding of the pathophysiologic mechanisms that may increase morbidity among individuals with HF and comorbid OSA, (2) a summary of current observational data and small randomized trials, (3) an understanding of the limitations of current larger randomized controlled trials, and (4) future needs to more accurately determine the efficacy of OSA treatment among individuals with HF.</jats:p

Obstructive Sleep Apnea in Heart Failure: Current Knowledge and Future Directions

Obstructive sleep apnea (OSA) is highly prevalent among patients with asymptomatic left ventricular systolic and diastolic dysfunction and congestive heart failure, and if untreated may contribute to the clinical progression of heart failure (HF). Given the health and economic burden of HF, identifying potential modifiable risk factors such as OSA and whether appropriate treatment improves outcomes is of critical importance. Identifying the subgroups of patients with OSA and HF who would benefit most from OSA treatment is another important point. This focused review surveys current knowledge of OSA and HF in order to provide: (1) a better understanding of the pathophysiologic mechanisms that may increase morbidity among individuals with HF and comorbid OSA, (2) a summary of current observational data and small randomized trials, (3) an understanding of the limitations of current larger randomized controlled trials, and (4) future needs to more accurately determine the efficacy of OSA treatment among individuals with HF