No abstract

Sleep apnea increases nighttime blood pressure variability in patients with hypertension and may be another pathway linking sleep abnormalities to cardiovascular disease.

Solid organ transplantation (SOT) saves the lives of patients suffering from end-stage liver, heart, kidney, pancreas, and lung diseases 1,2 and improves disease-related symptoms as well as the quality of life (QoL) in these individuals. 3 Recent statistics show that close to 100 800 solid organ transplants are performed every year worldwide. 4 Many SOT candidates suffer from chronic disease for years before receiving a transplant, and depending on their health condition and which organ is involved, multiple systems may be compromised. 5,6 Studies have shown that SOT candidates experience limitations in exercise capacity secondary to central and peripheral factors 6-9 which may impact their levels of daily physical activity 10-13 and consequently on the psychosocial aspects of their lives. 14 In the general population, physical inactivity reduces normal functioning of major organ systems such as the cardiovascular, cardiopulmonary,

In conclusion, simple questionnaire-based diagnostic tools can be included in the screening procedures of patients with angina to detect the need for further OSA evaluation. In conclusion, the BQ is an effective instrument for this purpose.

No abstract

In high cardiovascular risk hypertensive individuals with type 2 diabetes, ED is highly prevalent as expected, but its presence is associated with neither echocardiographic variables, nor other cardiovascular risk factors.

Home‐based exercise programs may offer a less costly alternative to providing exercise pre‐transplant to a large number of patients. We describe the changes in 6‐minute walk distance (6MWD) in lung transplant candidates who participated in a home‐based exercise program and their relationship to post‐transplant outcomes. Retrospectively, we investigated 159 individuals while awaiting transplantation who performed the surgery between 2011 and 2015. Primary outcome was 6MWD at time of assessment for transplant, last test prior to transplant and one‐month post‐transplant. 6MWD decreased by 28 ± 93.9 m between the time of assessment and the last 6MWD prior to transplantation (P < .001). Forty‐one patients (25.8%) increased their 6MWD (mean + 85.8 ± 42.8 m); 72 patients (45.3%) decreased their 6MWD (mean −109.8 ± 71.2 m); and 46 patients (28.9%) had no change in 6MWD (−1.5 ± 15.7 m). There was a moderate correlation (r = .528; P < .001) between the last 6MWD prior to transplant and 6MWD post‐transplant. Change in 6MWD prior to transplant weakly correlated with length of time on mechanical ventilation (r = −.185; P = .034). When adjusted for covariates, change in 6MWD prior to transplant was not associated with length of time on mechanical ventilation, total hospital LOS, or intensive care unit LOS. The majority of the patients were able to either increase or maintain their 6MWD while participating in a home‐based pre‐habilitation program during the waiting list period. Prospective research is needed to evaluate the effects of home‐based pre‐habilitation program for lung candidates.

Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > 50% in an epicardial coronary) or without significant coronary lesions. Controls were selected from a population-based sample. Positive BQ results were identified in 135 (41.2%) of 328 cases, in contrast with 151 (34.4%) of 439 control subjects (p = 0.03). In a multinomial logistic analysis, the risk for OSA identified by the BQ was independently associated with coronary artery disease in cases with lesions of at least 50% (OR = 1.53; 95%CI: 1.02-2.30; p = 0.04). The risk from OSA identified by the BQ was higher in younger subjects (40-59 years) (OR = 1.76; 95%CI: 1.05-2.97; p = 0.03) and in women (OR = 3.56; 95%CI: 1.64-7.72; p = 0.001). In conclusion, OSA identified by the BQ greatly increases the risks of coronary artery disease in patients having significant coronary artery lesions indicated by anangiogram, particularly in younger individuals and in women.