CPAP therapy induces favorable short-term changes in epicardial fat thickness and vascular and metabolic markers in apparently healthy subjects with obstructive sleep apnea-hypopnea syndrome (OSAHS)

Kostopoulos, Konstantinos; Alhanatis, Emmanouil; Παμπούκας, Κωνσταντίνος; Georgiopoulos, Georgios; Zourla, Andromahi; Panoutsopoulos, Athanasios; Kallianos, Anastasios; Velentza, Lemonia; Zarogoulidis, Paul; Trakada, Georgia

doi:10.1007/s11325-015-1236-5

Cited by 32 publications

(24 citation statements)

References 46 publications

(51 reference statements)

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“…Of interest, Parisi et al have pointed out that HF patients with sleep disordered-breathing have higher epicardial adipose tissue (EAT) thickness values than do HF patients without nocturnal apneas [39], which indicates EAT might be a pathophysiological link between OSAS and increased cardiovascular risk [31,33]. Besides, CPAP therapy reduces EAT and significantly ameliorates cardiometabolic parameters in obese OSAS patients [29]. Moreover, EAT is a source of several adipocytokines and directly affects the myocardium through vasocrine and paracrine mechanisms [24].…”

Section: Remodeling and Dysfunction In Osas Patientsmentioning

confidence: 99%

Left ventricular remodeling and dysfunction in obstructive sleep apnea

Liu

et al. 2019

Herz

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Background. Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular mortality and morbidity. Several studies have reported that it affects the left ventricle; however, large randomized controlled trials are lacking. The current study aimed to summarize the association between OSAS and left ventricular (LV) structure and function. Methods. Electronic databases (PubMed, Embase, and Cochrane) and references were searched for articles published until March 2018. A systematic review and metaanalysis were performed to assess LV structure and function in OSAS patients based on echocardiography.

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Section: Remodeling and Dysfunction In Osas Patientsmentioning

confidence: 99%

Left ventricular remodeling and dysfunction in obstructive sleep apnea

Liu

et al. 2019

Herz

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“…Increased fatty acid-triacylglycerol cycling may alter fat distribution - shifting fat from subcutaneous to visceral depots, to the liver, or into circulating lipoproteins. Some [67–70] but not other studies [71, 72] have shown regression of visceral adiposity in OSA patients after chronic CPAP therapy. In terms of hepatic fat, OSA is associated with non-alcoholic fatty liver disease [73–77].…”

Section: Empirical Datamentioning

confidence: 99%

Sleep apnea: An overlooked cause of lipotoxicity?

Younas

Jun

2017

Medical Hypotheses

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Obstructive sleep apnea (OSA) is a common sleep disorder associated with diabetes and cardiovascular disease. However, the mechanisms by which OSA causes cardiometabolic dysfunction are not fully elucidated. OSA increases plasma free fatty acids (FFA) during sleep, reflecting excessive adipose tissue lipolysis. In animal studies, intermittent hypoxia simulating OSA also increases FFA, and the increase is attenuated by beta-adrenergic blockade. In other contexts, excessive plasma FFA can lead to ectopic fat accumulation, insulin resistance, vascular dysfunction, and dyslipidemia. Herein, we propose that OSA is a cause of excessive adipose tissue lipolysis contributing towards systemic “lipotoxicity”. Since visceral and upper-body obesity contributes to OSA pathogenesis, OSA-induced lipolysis may further aggravate the consequences of this metabolically harmful state. If this hypothesis is correct, then OSA may represent a reversible risk factor for cardio-metabolic dysfunction, and this risk might be mitigated by preventing OSA-induced lipolysis during sleep.

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“…Treatment of OSA with continuous positive airway pressure (CPAP) during 24 weeks significantly reduced EFT in 28 symptomatic OSA patients with AHI > 15, without significant change in BMI or waist circumference(36). Shorter-term of CPAP treatment (3 months) in 25 compliant OSA patients also reduced EFT(159), but in another study EAT remained higher in CPAP treated OSA obese patients (n=19, mean BMI The prognostic impact of EAT reduction by CPAP therapy on cardiovascular outcomes need to be further explored by large prospective studies. In all, EAT is increased in OSA patients and is a correlate of OSA severity.…”

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confidence: 99%

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Gaborit

Sengenès

Ancel

et al. 2017

Comprehensive Physiology

119

109

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Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.

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CPAP therapy induces favorable short-term changes in epicardial fat thickness and vascular and metabolic markers in apparently healthy subjects with obstructive sleep apnea-hypopnea syndrome (OSAHS)

Cited by 32 publications

References 46 publications

Left ventricular remodeling and dysfunction in obstructive sleep apnea

Left ventricular remodeling and dysfunction in obstructive sleep apnea

Sleep apnea: An overlooked cause of lipotoxicity?

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

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