Disordered Breathing and Hypoxia during Sleep in Coronary Artery Disease

Olazabal, Jose R. De; Miller, Michael J.; Cook, William R.; Mithoefer, John C.

doi:10.1378/chest.82.5.548

Cited by 70 publications

(21 citation statements)

References 23 publications

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“…Increased oxygen demand and reduced oxygen supply, i.e. hypoxaemia, following sleep-disordered breathing may trigger an attack of angina pectoris in patients with CAD who already exhibit reduced coronary flow reserve [20,25].…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up

Peker¹,

Carlson²,

Hedner³

2006

European Respiratory Journal

379

188

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An increased incidence of cardiovascular disease has previously been reported in middle-aged males during a follow-up period of 7 yrs. The aim of the present study was to address the incidence of coronary artery disease (CAD) in a larger sample without any heart disease at baseline.The population comprised 308 snorers (245 males and 63 females) with a mean¡SD age of 49.0¡9.9 yrs in 1991. Data were collected via the Swedish Hospital Discharge Register, National Cause of Death Registry, clinical charts and questionnaires.Over 7 yrs, CAD was observed in 17 (16.2%) of 105 patients with obstructive sleep apnoea (OSA; overnight (6 h) oxygen desaturations o30 events) compared with 11 (5.4%) of 203 snorers without OSA. OSA diagnosis at baseline was associated with an increased risk of development of CAD in a multivariate model. In the OSA group, CAD was confirmed in 16 (24.6%) of 65 incompletely treated patients compared with one (3.9%) of 26 efficiently treated subjects. Efficient treatment of OSA reduced this risk.It is concluded that middle-aged sleep apnoeics are at high risk of developing coronary artery disease if they are not treated efficiently, which should be considered in cardiovascular disease prevention models.

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Section: Discussionmentioning

confidence: 99%

Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up

Peker¹,

Carlson²,

Hedner³

2006

European Respiratory Journal

379

188

View full text Add to dashboard Cite

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“…Technological advances have led to the development of high frequency (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) ultrasound transducers, which can be positioned within the coronary tree [21]. This generates high-quality tomographic images of vessels [22].…”

Section: Introductionmentioning

confidence: 99%

Relationship between atherosclerosis and the sleep apnea syndrome: An intravascular ultrasound study

Turmel

Sériès

Boulet

et al. 2009

International Journal of Cardiology

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“…Hence, a low prevalence of un derlying cardiac disease in our subjects could account for the relatively low incidence of significant arrhythmias and absence of myocardial ischemia we observed during sleep. In a study of patients with angiographically proven coronary artery disease and disordered breathing during sleep, De Olzabal et al [36] found no significant relation ships between apneas or desaturations and the develop ment of arrhythmias. However, the patients in that study had a mean apnea/hypopnea index of only 20, and oxygen desaturation was not severe.…”

Section: Discussionmentioning

confidence: 96%

Cardiac Disturbances in Patients with Obstructive Sleep Apnea

Cheong¹,

Sami²,

Kimoff³

et al. 1992

Am J Noninvas Cardiol

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We studied the effect of nasal continuous positive airway pressure (nCPAP) on the occurrences of cardiac disturbances in 24 subjects with severe obstructive sleep apnea (OSA). Fifty percent of subjects were hypertensive, but none had symptoms or physical signs suggestive of cardiac disease. Subjects underwent overnight polysomnography with Holter monitoring on 2 consecutive nights (control and nCPAP). nCPAP significantly reduced the apnea/hypopnea index from 66 ± 5 events/h (mean ± SEM) on control nights to 6 ± 1 (p < 0.001 ). With nCPAP, only 7 ± 2 % of the night was spent with an arterial oxyhemoglobin saturation <90% as compared with 50 ± 5% on control nights (p < 0.001). No silent myocardial ischemia, severe bradycardia (HR < 30/min for > 1 min) or second degree A-V block were seen during either night. Prolonged sinus pauses (>2 s) were present in 2 subjects on control nights only, and were completely alleviated by nCPAP. Fifteen subjects (63 %) had ventricular premature beats (VPB) on control nights and in 5, these were complex (multiform or repetitive). With nCPAP, 13 subjects had VPB which were complex in 5. The group mean for VPB frequency was not significantly different between study nights. In conclusion, ventricular arrhythmias were common, whereas silent myocardial ischemia was not seen in patients with severe OSA with no evident heart disease. nCPAP relieved all sinus pauses, but had no significant effect on ventricular arrhythmias in this patient population. nCPAP may have a more important effect on cardiac disturbances in patients with OSA and coexistent significant cardiac disease.

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Disordered Breathing and Hypoxia during Sleep in Coronary Artery Disease

Cited by 70 publications

References 23 publications

Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up

Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up

Relationship between atherosclerosis and the sleep apnea syndrome: An intravascular ultrasound study

Cardiac Disturbances in Patients with Obstructive Sleep Apnea

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