Influence of Untreated Sleep-Disordered Breathing on the Long-Term Prognosis of Patients With Cardiovascular Disease

Takama, Noriaki; Kurabayashi, Masahiko

doi:10.1016/j.amjcard.2008.10.035

Cited by 54 publications

(27 citation statements)

References 29 publications

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“…Intermittent episodes of hypoxia as a result of transient cessation of breathing during sleep are major physiologic characteristics of OSAS which resemble symptoms of ischemia-reperfusion injury. Intermittent episodes of nocturnal hypoxemia induce formation of oxygen-free radicals leading to a state of low-grade circulation and inflammation [28]. Inflammation is one of the fundamental factors contributing to the onset, and progression of atherosclerosis [29].…”

Section: Discussionmentioning

confidence: 99%

Platelet–lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome

Köseoğlu

Altunkaş

Kanbay

et al. 2014

J Thromb Thrombolysis

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There is a strong relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease (CVD). Chronic intermittent hypoxia, inflammation, oxidative stress, and endothelial dysfunction may constitute etiologic mechanisms, linking OSAS to CVD. Inflammation play an important role in the development of CVD. Platelet-lymphocyte ratio (PLR) is a new biomarker showing inflammation. No previous study has ever investigated the association between PLR, CVD and OSAS severity in patients with OSAS. This study was designed to investigate the association between PLR and CVD in patients with OSAS, and relationship between severity of OSAS, polysomnographic parameters and PLR. This was a cohort study in which patients who had undergone a full night polysomnoraphy for diagnosis of OSA were recruited. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (Group 1: AHI < 5), mild (Group 2: AHI, 5-15), moderate (Group 3:AHI,15-30), and severe OSAS (Group 4: AHI > 30) groups. The presence of heart failure, coronary artery disease or arrhythmia was defined as CVD. A total of 424 patients were included in this study. There were 57, 93, 82, and 192 patients in Groups 1, 2, 3, and 4, respectively. PLR were significantly different between groups (Group 1: 87.38; Group 2: 95.07; Group 3: 97.01, Group 4: 126.9, P < 0.05). PLR were significantly correlated with AHI, oxygen desaturation index, average and minimum O2 saturation values (P < 0.05). Values of PLR were significantly higher in patients with CVD compared with those without. Multiple regression analysis demonstrated that PLR is an independent predictor of CVD. PLR cut-off value for demonstrating the presence of CVD is higher than 108.56. In the light oh findings, PLR is strongly associated with the severity of OSAS and cardiovascular disease in OSAS patients. PLR might be used as a biomarker to predict CVD in OSAS patients.

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Section: Discussionmentioning

confidence: 99%

Platelet–lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome

Köseoğlu

Altunkaş

Kanbay

et al. 2014

J Thromb Thrombolysis

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“…In addition to its high prevalence, it is considered to be a cardiovascular risk factor (4,5,19). OSA has been reported to produce endothelial dysfunction and to facilitate atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

et al. 2012

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Objective To evaluate the impact of oxidative stress and cellular adhesion molecules on ischemic reactive hyperemia (IRH) in patients with OSA. Materials and MethodsConsecutive patients treated at a sleep laboratory and whose polysomnography showed an apnea hypopnea index (AHI) " 5 were included in the study. Patients with acute illness receiving vasoactive medications were excluded. Based on their oxygen desaturation index (ODI), subjects were assigned to the mild-moderate (ODI !30) or the severe desaturation group (ODI >30). Then IRH and oxidative stress markers [malondialdehyde (MDA)] and proinflammatory markers (ICAM-1 and P-selectin) were measured. Results Sixty-eight subjects with OSA were included, 31 in the mild-moderate desaturation group and 37 in the severe group. No differences by age, gender and body mass index were observed. The severe desaturation group showed significantly higher values in the AHI, MDA, ICAM-1 and P-selectin (p<0.005), as well as a worsening of IRH (p=0.001). Only ICAM-1 (p=0.019) and P-selectin (p=0.033) were independently associated with IRH in a multiple-linear regression model. Conclusion Patients with OSA and greater intermittent hypoxia showed worse endothelial function, and higher levels of MDA, ICAM-1 and P-selectin. Nevertheless, ICAM-1 and P-selectin rather than MDA were independently associated with IRH.

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“…If untreated, this disorder can lead to extensive daytime sleepiness 3 and an elevated risk for cardiovascular disease. [4][5][6] The main criteria used to indicate the severity of OSA is the apneahypopnea index (AHI), which describes the mean number of breathing pauses longer than 10 seconds per hour of sleep. Breathing pauses are divided into the categories apnea or hypopnea.…”

Section: Introductionmentioning

confidence: 99%

Validation of a New System Using Tracheal Body Sound and Movement Data for Automated Apnea-Hypopnea Index Estimation

Kalkbrenner

Eichenlaub

Rüdiger

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: The current gold standard for assessment of obstructive sleep apnea is the in-laboratory polysomnography. This approach has high costs and inconveniences the patient, whereas alternative ambulatory systems are limited by reduced diagnostic abilities (type 4 monitors, 1 or 2 channels) or extensive setup (type 3 monitors, at least 4 channels). The current study therefore aims to validate a simplified automated type 4 monitoring system using tracheal body sound and movement data. Methods: Data from 60 subjects were recorded at the University Hospital Ulm. All subjects have been regular patients referred to the sleep center with suspicion of sleep-related breathing disorders. Four recordings were excluded because of faulty data. The study was of prospective design. Subjects underwent a full-night screening using diagnostic in-laboratory polysomnography and the new monitoring system concurrently. The apnea-hypopnea index (AHI) was scored blindly by a medical technician using in-laboratory polysomnography (AHIPSG). A unique algorithm was developed to estimate the apneahypopnea index (AHIest) using the new sleep monitor. Results: AHIest strongly correlates with AHIPSG (r 2 = .9871). A mean ± 1.96 standard deviation difference between AHIest and AHIPSG of 1.2 ± 5.14 was achieved. In terms of classifying subjects into groups of mild, moderate, and severe sleep apnea, the evaluated new sleep monitor shows a strong correlation with the results obtained by polysomnography (Cohen kappa > 0.81). These results outperform previously introduced similar approaches. Conclusions:The proposed sleep monitor accurately estimates AHI and diagnoses sleep apnea and its severity. This minimalistic approach may address the need for a simple yet reliable diagnosis of sleep apnea in an ambulatory setting. Clinical Trial Registration: Trial name: Validation of a new method for ambulant diagnosis of sleep related breathing disorders using body sound; URL: https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011195; Identifier: DRKS00011195 Keywords: monitoring, movement analysis, respiratory sounds, sleep apnea Citation: Kalkbrenner C, Eichenlaub M, Rüdiger S, Kropf-Sanchen C, Brucher R, Rottbauer W. Validation of a new system using tracheal body sound and movement data for automated apnea-hypopnea index estimation. J Clin Sleep Med. 2017;13(10):1123-1130. I NTRO DUCTI O NWith a prevalence of 4% in adult men and 2% in women, obstructive sleep apnea (OSA) is one of the most common sleeprelated breathing disorders.1 Additionally, more than 75% of people suffering from moderate OSA are either undiagnosed or untreated.2 OSA is characterized by multiple breathing cessations during the night due to different possible causes. If untreated, this disorder can lead to extensive daytime sleepiness 3 and an elevated risk for cardiovascular disease. [4][5][6] The main criteria used to indicate the severity of OSA is the apneahypopnea index (AHI), which describes the mean number of breathing pa...

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Influence of Untreated Sleep-Disordered Breathing on the Long-Term Prognosis of Patients With Cardiovascular Disease

Cited by 54 publications

References 29 publications

Platelet–lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome

Platelet–lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

Validation of a New System Using Tracheal Body Sound and Movement Data for Automated Apnea-Hypopnea Index Estimation

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