Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Otsuka, Kuniaki; Sadakane, Noriko; Ozawa, Toshio

doi:10.1002/clc.4960101201

Cited by 13 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is an association between habitual snoring and/or obstructive sleep apnea and cardiac arrhythmias (Gillis, 1985;Peiser et al, 1985;Otsuka et al, 1987;Shepard, 1992;Adlakha and Shepard, 1998;Kohler et al, 1998;Sanner et al, 1999;Porthan et al, 2004).…”

Section: Heart Diseasementioning

confidence: 99%

Epidemiology of sleep disorders

Partinen

2011

Handbook of Clinical Neurology

View full text Add to dashboard Cite

Section: Heart Diseasementioning

confidence: 99%

Epidemiology of sleep disorders

Partinen

2011

Handbook of Clinical Neurology

View full text Add to dashboard Cite

“…In the early days of sleep research, heart block (second and third degree atrioventricular block [II° and III° AV block]), sinus arrest or sinuatrial block were thought to be highly prevalent in patients with OSA, and the reported incidence ranged between 18% and 50%[167, 235]. More recent data of unselected patients treated in a sleep laboratory revealed prevalence rates between 7% and 13%[15, 22, 142].…”

Section: Heart Blockmentioning

confidence: 99%

Sleep-Disordered Breathing and Cardio- and Cerebrovascular Diseases: 2003 Update of Clinical Significance and Future Perspectives. Schlafbezogene Atmungsstorungen und kardio- und zerebrovaskulare Erkrankungen: Update 2003 der klinischen Bedeutung und zukunftiger Entwicklungen

et al. 2003

View full text Add to dashboard Cite

The purpose of this review is to summarize current knowledge about the link between sleepdisordered breathing (SDB) and cardiovascular and cerebrovascular diseases. Obstructive sleep apnoea (OSA) is a well-established risk factor for systemic arterial hypertension, and its treatment with continuous positive airway pressure leads to a decrease in daytime and night-time blood pressure profiles. Pulmonary arterial hypertension occurs in 20-30% of OSA patients and is usually mild. It is not yet clear if OSA per se leads to pulmonary hypertension or if the coexistence of chronic obstructive pulmonary disease with daytime and/or sleep-related hypoxaemia is required to provoke a persistent rise in pulmonary artery pressure. Furthermore, OSA is associated with nocturnal cardiac arrhythmias, especially cyclical fluctuations of the heart rate in response to recurrent apnoeas. Atrioventricular conduction blocks and ventricular premature beats are less often observed and seem to be confined to patients with severe OSA and those with accompanying ischaemic heart disease. The association between OSA and vaso-occlusive disease (i.e. atherosclerosis) is less clear. However, accumulating experimental and epidemiological data support such a link. Thus, OSA may lead to coronary artery disease (CAD) and stroke by promoting atherosclerosis. Correspondingly, patients with CAD or acute stroke show a high prevalence of SDB. Cheyne-Stokes respiration (CSR) is a specific pattern of central sleep apnoea occurring in patients with advanced congestive heart failure (CHF). If present, CSR clearly has a negative impact on the clinical course of CHF. Although the optimal treatment strategy for CSR is less well defined than that for OSA, the successful reversal of CSR might increase overall survival in affected patients.Keywords Sleep-disordered breathing -obstructive sleep apnoea -central sleep apnoea -Cheyne -Stokes breathing -pulmonary disease -cardiovascular disease -hypertensionstroke. ZusammenfassungZiel dieser Ü bersichtsarbeit ist die Darstellung aktueller Zusammenhänge zwischen schlafbezogenen Atmungsstö rungen und kardio-bzw. zerebrovaskulären Erkrankungen: Das obstruktive Schlafapnoe-Syndrom (OSAS) ist als unabhängiger Risikofaktor fü r die Entstehung einer arteriellen Hypertonie anzusehen. Die nasale Ü berdruck-Therapie (CPAP) fü hrt zu einer Senkung des Tages-und Nachtblutdruckes. Ca. 20-30% der Patienten mit OSAS weisen eine pulmonal-arterielle Hypertonie auf; unklar ist jedoch, ob eine zusätzliche Lungenerkrankung mit Tages-und/oder Nachthypoxämie eine notwendige Voraussetzung zur Entstehung der pulmonal-arteriellen Hypertonie bei diesen Patienten ist. Herzrhythmusstö rungen, insbesondere apnoebedingte Schwankungen der Herzfrequenz, treten bei OSAS gehäuft auf. Atrioventrikuläre Blockbilder oder ventrikuläre Extrasystolen sind seltener anzutreffen und scheinen auf schwere Formen des OSAS und solche mit zusätzlicher koronarer Herzkrankheit beschränkt zu sein. Die Zusammenhänge zwischen OSAS und der Entwicklung einer Arteriosklerose...

show abstract

“…There was cardiac disorders, but patients with left nean ejection frac-ventricular impairment were not specifically > III arrhythmias included. 8 Dark et al showed an improvement tith grade <III in oxygen saturation after treatment of heart ompared with 27 failure in six patients with left ventricular dysfunction, but no analysis of arrhythmia was undertaken. 9 Hanly et al carried out oximetry IYTHMIAS AND in 10 outpatients with chronic heart failure and showed poor quality of sleep with frequent dips n between severity and arousals, but again arrhythmias were not de > III v Lown analysed.…”

Section: Electrocardiographic Monitoringmentioning

confidence: 99%

Nocturnal hypoxia and arrhythmias in patients with impaired left ventricular function

Cripps

Rocker²,

Stradling³

1992

Heart

View full text Add to dashboard Cite

Objectives-To document the incidence of hypoxic episodes in a series of patients with impaired left ventricular function, and to correlate the occurrence of hypoxia with severity of arrhythmia.Patients-34 patients with breathlessness and clinical evidence of left ventricular dysfunction.Main outcome measures-Simultaneous overnight finger oximetry and electrocardiographic monitoring.Results (Br Heart J 1992;68:382-6) Nocturnal hypoxia due to disordered breathing is described in patients with chronic obstructive pulmonary disease'2 and may be associated with cardiac arrhythmias." The greatest expression of the arrhythmogenic effect of hypoxia might, however, be expected in those with intrinsic myocardial disease, particularly in patients with impaired left ventricular function, in whom ventricular arrhythmias are frequent and easily precipitated.56 The purpose of this study was to examine fluctuations in nocturnal oxygen saturation in a group of patients with impaired left ventricular function, and to correlate these fluctuations with the occurrence of ventricular arrhythmias and the severity of left ventricular impairment. Patients and methods PATIENTSPatients were selected from those admitted to hospital for elective cardiac catheterisation, or for treatment of refractory chronic heart failure. Those considered to have impaired left ventricular function were identified clinically on the basis of a history of dyspnoea, a cardiothoracic ratio >50% on a chest radiograph, and clinical signs suggestive of left ventricular impairment. All had New York Heart Association (NYHA) grade II-IV dyspnoea. Patients were excluded if they gave a history suggestive of chronic bronchitis, asthma, chronic airways obstruction, or other intrinsic pulmonary disease, but formal lung function tests were not performed. None of the patients had symptoms suggestive of obstructive sleep apnoea, and none were grossly obese ( > 115% of ideal body weight). Each patient gave informed consent; the study was approved by the hospital ethics committee. OXIMETRYOvernight oximetry was performed at the bedside with an Ohmeda Biox 3700 pulse oximeter (version J) and a flexible finger probe.7 The device's internal memory stores a two digit value at the end of each 12 seconds, which represents the lowest oxygen saturation during those 12 seconds. Thus dips in saturation are not missed but recovery between dips may be underestimated. The 2400 values for oxygen saturation generated over an eight hour period were subsequently downloaded to an IBM compatible personal computer and analysed for mean saturation and dips in excess of 4%. Dips were counted when the saturation fell more than 4% below the previous updated high. No further dip was recorded unless the saturation rose by more than 3%. The probe was applied to the forefinger of either hand late in the evening as the patient was preparing to retire and was removed the next morning. We performed the study on the second or later night in hospital, so that the patient was accustomed to his surr...

show abstract

Arrhythmogenic properties of disordered breathing during sleep in patients with cardiovascular disorders

Cited by 13 publications

References 19 publications

Epidemiology of sleep disorders

Epidemiology of sleep disorders

Sleep-Disordered Breathing and Cardio- and Cerebrovascular Diseases: 2003 Update of Clinical Significance and Future Perspectives. Schlafbezogene Atmungsstorungen und kardio- und zerebrovaskulare Erkrankungen: Update 2003 der klinischen Bedeutung und zukunftiger Entwicklungen

Nocturnal hypoxia and arrhythmias in patients with impaired left ventricular function

Contact Info

Product

Resources

About