The purpose of this study was to determine the relationship between obstructive sleep apnea (OSA) and cardiovascular disorders in a large Japanese population, and to assess the efficacy of continuous positive airway pressure (CPAP) in the treatment of OSA-associated arrhythmias. The study population comprised 1394 Japanese subjects (1086 men and 308 women) who were divided into four groups on the basis of polysomnography (PSG) analysis as follows: the no sleep apnea (N-SA) group (n = 44, apnea-hypopnea index [AHI] < 5), the mild OSA (Mi-OSA) group (n = 197, 5 < AHI < 15), the moderate OSA (Mo) group (n = 368, 15 < AHI < 30), and severe OSA (SOSA) group (n = 785, AHI < 30). The following baseline characteristics were significantly associated with OSA: age (P < 0.001), gender (P < 0.001), body mass index (P < 0.001), hypertension (P < 0.001), diabetes (P = 0.009), and hyperlipidemia (P = 0.013). In the OSA group, PSG revealed the predominance of paroxysmal atrial fibrillation (PAF) (P = 0.051), premature atrial complex short run (P < 0.005), premature ventricular complex (PVC, P = 0.004), sinus bradycardia (P = 0.036), and sinus pause (arrest >2 s, P < 0.001) during the PSG recording. A total of 316 patients from the group underwent CPAP titration and were then re-evaluated. Continuous positive airway pressure therapy significantly reduced the occurrences of PAF (P < 0.001), PVC (P = 0.016), sinus bradycardia (P = 0.001), and sinus pause (P = 0.004). The results of this study demonstrate a significant relationship between OSA and several cardiac disorders, and also demonstrate the efficacy of CPAP in preventing OSA-associated arrhythmias in a large population of Japanese patients.

Background:Interleukin (IL)-13 has recently been reported as the major T-helper 2 cytokine involved in mucus overproduction and oversecretion in allergic airways. However, the relationship between human calcium-activated chloride channel-1 (hCLCA1) and MUC5AC induced by IL-13 in vitro has not been fully investigated. Objectives: The present study examines whether IL-13 induces the expression of hCLCA1 in normal human bronchial epithelial (NHBE) cells. We also investigated the relationship between hCLCA1 and MUC5AC expression and the development of goblet cell hyperplasia (GCH). Methods: NHBE cells were isolated from human bronchi, and cultured with an air-liquid interface. hCLCA1 and MUC5AC gene and protein expression, as well as GCH were examined in the cells after exposure to IL-13. Results: Incubation with IL-13 for 14 and 21 days increased the total number of epithelial cells, the number of periodic acid-Schiff (PAS)-stained epithelial cells, the number of goblet cells, as well as expression of mRNA and protein of hCLCA1 and MUC5AC. The number of goblet cells with secretory granules also increased after 21 days of incubation with IL-13. Niflumic acid, a chloride channel inhibitor, reduced mRNA expression of hCLCA1 and MUC5AC, and reduced the number of PAS-positive cells after incubation with IL-13. NHBE cells exposed or not to IL-13 expressed IL-13 receptor α₁ (IL-13Rα₁), and an antibody to IL-13 Rα₁ also reduced the number of PAS-positive cells after exposure to IL-13. Conclusions: IL-13 might induce the expression of MUC5AC and hCLCA1 gene and protein in well-differentiated NHBE cells. These cells might also differentiate into goblet cells and become hyperplastic.

Objective The prevalence of complex sleep apnea syndrome (CompSAS)

No abstract

OBJECTIVES: The purpose of this study was to determine the relationship between Sleep-disordered breathing (SDB) and cardiovascular disorders in a large Japanese population, and to assess the efficacy of continuous positive airway pressure (CPAP) in the treatment of SDB-associated arrhythmias. BACKGROUND: SDB is associated with cardiovascular disorders, such as hypertension, ischemic heart disease, and arrhythmias, and CPAP is one of the effective treatments for SDB; however, this relationship and the efficacy of CPAP treatment in a large population of Japanese patients remain undefined. METHODS AND RESULTS: The study population comprised 1413 Japanese subjects (mean age: 56.6 years old, 1123 men and 290 women) who were divided into 2 groups: SDB group ( n = 1064, apnea-hypopnea index (AHI)≥20)and control group ( n = 349, AHI < 20) by polysomnography (PSG) analysis. In baseline characteristics, age (58.3±14.7vs.50.0±18.4, p <0.0001), gender (male: 88.4%vs.72.9%, p <0.0001), BMI (25.9±4.4vs.23.2±3.7, p <0.0001), hypertension (38.0%vs.19.3%, p <0.0001), diabetes (10.4%vs.5.2%, p =0.015), or hyperlipidemia (15.6%vs.9.3%, p =0.018) were significantly associated with SDB. PSG revealed predominant occurrence of paroxysmal atrial fibrillation (PAF: 108/1064 vs. 3/349, p=0.005), premature ventricular complex (PVC: 359/1064vs.17/349, p=0.0012) and pause (sinus arrest ≥2 sec: 172/859vs.6/349, p=0.002) in SDB group. In the SDB group, 291 patients underwent CPAP titration and were then re-evaluated. CPAP therapy significantly reduced the occurrences of PAF (59/291vs.2/291, p=0.005), sinus bradycardia (18/291vs.0/291, p=0.002), and sinus pause (26/291 vs. 4/291, p=0.016). CONCLUSIONS: The results of this study provide a significant relationship between SDB and several cardiac disorders, and efficacy of CPAP in preventing SDB-associated arrhythmias in a large population of Japanese patients. Effect of CPAP on the arryhthmic events in patients with SAS during PSG recording