Obstructive Sleep Apnea Syndrome in Congestive Heart Failure: Cardiologist  Perspective

Медведева, Е. А.; Korostovtseva, Lyudmila; Сазонова, Ю. В.; Бочкарёв, Михаил Викторович; Свиряев, Ю. В.; Konradi, Alexandra

doi:10.15829/1560-4071-2018-1-78-82

Cited by 12 publications

(2 citation statements)

References 21 publications

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“…Дефицит эстрогенов, влияя на липидный обмен, может приводить к развитию ожирения, распространенность которого возрастает по мере прогрессирования климактерия и которое является одним из важных факторов развития СОАС [25]. Накопление подкожного жира в области грудной клетки и шеи значительно повышает риск коллапса верхних дыхательных путей [26]. Полученные в данном исследовании результаты демонстрируют развитие гиперлипидемии у пациенток с СОАС, наиболее выраженной в постменопаузе, где степень тяжести СОАС выше по сравнению с перименопаузальным перио-дом.…”

Section: îáñóAeäåíèåunclassified

Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome

Kolesnikova

Semenova

Osipova

et al. 2019

Terapevticheskii arkhiv

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Aim: to assess lipid profile, lipid peroxidation and antioxidant system parameters in peri - and postmenopausal women with obstructive sleep apnea syndrome (OSAS). Materials and methods. 37 perimenopausal women and 43 postmenopausal ones were examined. OSAS diagnosis was made on the basis of the clinical picture and the polysomnography results. In perimenopause, the main group consisted of 18 women, in postmenopausal women - 17. All comparison groups are comparable by age and body mass index. Lipid profile, lipid peroxidation and antioxidant system parameters by spectrophotometric methods were determined. Non - parametric criteria were used to analyze the group differences for the independent samples. Results and discussion. The increase of total cholesterol (TC) and low - density lipoprotein cholesterol (LDL-C) levels were observed in perimenopausal women with OSAS as compared to control. The increase of TC, triacylglycerol (TG), LDL-C, very - low - density lipoprotein cholesterol (VLDL-C) levels and decrease of high - density lipoprotein cholesterol (HDL-D) level were found in postmenopausal women with OSAS as compared to control. Accumulation of ketodienes and conjugated trienes in perimenopausal women with OSAS and thiobarbituric acid reactants with a decrease of total antioxidant activity of blood serum in postmenopausal women with OSAS as compared to control was observed. Moreover, postmenopausal women with OSAS have a higher lipid peroxidation substrates and diene conjugates levels with a lower α-tocopherol level and total antioxidant activity compared with perimenopausal patients.The integral indicator of oxidative stress assessment indicates an imbalance in the lipid peroxidation and antioxidant system in menopausal women with OSAS. Conclusion. The results obtained indicate a violation of lipid metabolism and the development of oxidative stress in patients with OSAS. This is most pronounced in the postmenopause due to the aggravation of the pathological condition.

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Section: îáñóAeäåíèåunclassified

Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome

Kolesnikova

Semenova

Osipova

et al. 2019

Terapevticheskii arkhiv

View full text Add to dashboard Cite

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“…Кроме того, активация симпатической нервной системы при ОАС способствует сужению периферических сосудов, и вызывает повышение артериального давления и частоты сердечных сокращений. Системная гипертензия также может способствовать гипертрофии сердца, диастолической дисфункции и потенциально привести к сердечной недостаточности [6]. Кроме того, повышенное отрицательное внутригрудное давление, вызванное окклюзией дыхательных путей и, как следствие, повышенным дыхательным усилием, создает дополнительную механическую нагрузку на сердце, что приводит к прогрессированию сердечного ремоделирования [7].…”

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Role of biomarkers of collagen metabolism and systemic inflammation in myocardial remodeling in patients with stable chronic coronary artery disease and obstructive sleep apnea

Osipova,

Gosteva,

Petrichko

et al. 2023

Cardiovasc Ther Prev

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Aim. To study the relationship of biomarkers of collagen metabolism and systemic inflammation with left ventricular (LV) remodeling in patients with stable coronary artery disease (CAD) and obstructive sleep apnea (OSA).Material and methods. The study included 195 patients with stable CAD, of which 63 without OSA and 132 patients with combination of CAD and OSA. The mean age of patients was 63,4±3,7 years. Biomarkers of collagen metabolism and systemic inflammation were assessed by determining the concentration of matrix metalloproteinase (MMP)-9, tissue inhibitor of matrix metalloproteinase-1, monocyte chemoattractant protein-1 (MCP-1) and calculating the neutrophil-to-lymphocyte (NLR) and platelet-tolymphocyte ratio (PLR). Echocardiography was performed according to a standard protocol.Results. There were no significant differences in systemic inflammation parameters (MCP-1, NLR, PLR) between the group of patients with CAD and CAD with mild OSA and a significantly higher level of MCP-1, NLR, PLR in more severe OSA. In patients with CAD and severe OSA, the eccentric LV remodeling was diagnosed in 75% of individuals, while the concentric type was diagnosed in only 25%.Conclusion. In patients with stable CAD, the more severe the OSA, the more pronounced systemic inflammation (MCP-1, NLR, PLR), and there are higher proportion of eccentric LV hypertrophy, which may be associated with an imbalance of fibrosis markers (high concentration of MMP-9 with an almost unchanged level of tissue inhibitor of MMP-1).

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Sleep-related breathing disorders in patients with heart failure with reduced and mildly reduced ejection fraction: main types and their dependence on heart failure etiology

Krupichka¹,

Agaltsov²,

Beregovskaya³

et al. 2023

Russ J Cardiol

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Aim. To identify and study the nature of sleep-related breathing disorders (SBDs) in a cohort of hospitalized patients with heart failure (HF) with reduced and mildly reduced ejection fraction (EF), as well as to clarify the relationship between SBD type, etiology and severity of HF.Material and methods. The study included 117 patients with HF with reduced and mildly reduced ejection fraction hospitalized at the National Medical Research Center for Therapy and Preventive Medicine from 2019 to 2021. All patients underwent clinical and paraclinical examination, including cardiorespiratory sleep study. Patients were divided into three groups according to the type and severity of SBD: no or mild SBD, predominantly with obstructive sleep apnea (OSA) and predominantly with central sleep apnea (CSA). Severity of SBD and clinical data were compared between these groups.Results. A total of 5 patients (4,27%) did not have any SBDs, while 47 (40,17%) were diagnosed with CSA, and 65 (55,56%) — OSA of varying severity. The proportions of patients with moderate and severe CSA and OSA differed insignificantly and amounted to 35,9% (n=42) and 44,4% (n=52), respectively. There were following proportions of diseases related to HF: coronary artery disease (41,88%), nonischemic cardiomyopathy (26,5%), arrhythmogenic cardiomyopathy (15,38%) and other causes (16,24%) (hypertension, myocarditis, heart defects). We found that reduced EF <40%, end-diastolic volume >210 ml, and ventricular ectopy (>300 extrasystoles/day) were associated with CSA, and body mass index >30 kg/m2 was traditionally associated with OSA.Conclusion. More than half of HF patients with reduced and mildly reduced EF have SBDs. Decreased LVEF and ventricular ectopic activity are associated with CSA, while increased body mass index is associated with OSA. Consideration of SBD risk factors may improve patient phenotyping for individualized therapy.

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Obstructive Sleep Apnea Syndrome in Congestive Heart Failure: Cardiologist Perspective

Cited by 12 publications

References 21 publications

Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome

Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome

Role of biomarkers of collagen metabolism and systemic inflammation in myocardial remodeling in patients with stable chronic coronary artery disease and obstructive sleep apnea

Sleep-related breathing disorders in patients with heart failure with reduced and mildly reduced ejection fraction: main types and their dependence on heart failure etiology

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