Prevalence of Sleep-Disordered Breathing in Diastolic Heart Failure

Chan, Joseph Yat Sun; Sanderson, John E.; Chan, Wilson; Lai, Ching‐Long; Choy, D.; Ho, Alice; Leung, Roland

doi:10.1378/chest.111.6.1488

Cited by 209 publications

(129 citation statements)

References 25 publications

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“…However, in both studies, central sleep apnoea was seen more often than in our study, possibly because our patients were at an earlier stage of cardiac disease. This may be explained by the fact that most of our patients had only diastolic dysfunction, not symptomatic HFprEF as in the above-mentioned papers [39,40]. Our results of an independent association of OSA with diastolic dysfunction support the concept of treating OSA to improve diastolic function and to prevent symptomatic HFprEF.…”

Section: Osa and Diastolic Dysfunctionsupporting

confidence: 71%

“…Our results are in agreement with BITTER et al [39], who reported a higher prevalence of OSA (40%) than central sleep apnoea (30%) in patients suffering from symptomatic HFprEF. Furthermore, CHAN et al [40] demonstrated in a small study of symptomatic HFprEF a prevalence of sleep-disordered breathing of 55%, with a majority of these patients suffering from OSA. However, in both studies, central sleep apnoea was seen more often than in our study, possibly because our patients were at an earlier stage of cardiac disease.…”

Section: Osa and Diastolic Dysfunctionmentioning

confidence: 99%

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Impact of obstructive sleep apnoea on diastolic function

et al. 2012

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We investigated whether obstructive sleep apnoea (OSA) independently affects diastolic function in a primary care cohort of patients with cardiovascular risk factors.378 study participants with risk factors for diastolic dysfunction were prospectively included and a polygraphy was performed in all patients. Diastolic dysfunction was assessed by comprehensive echocardiography including tissue Doppler. Sleep apnoea was classified according to apnoea/ hypopnoea index (AHI) as none (AHI ,5 events?h ). Patients with central sleep apnoea (n514) and patients with previously diagnosed sleep apnoea (n512) were excluded. In the remaining 352 subjects, 21.6% had an AHI o15 events?h -1 . The prevalence of diastolic dysfunction increased with the severity of sleep apnoea from 44.8% (none) to 56.8% (mild) to 69.7% (moderate-to-severe sleep apnoea) (p50.002). The degree of diastolic dysfunction also increased with sleep apnoea severity (p50.004). In univariate regression analysis, age, desaturation index, AHI, cardiac frequency, angiotensin receptor 1 antagonist therapy, body mass index (BMI) and left ventricular mass were associated with diastolic dysfunction. In multivariate regression analysis, only age, BMI, AHI and cardiac frequency were independently associated with diastolic dysfunction.Moderate-to-severe OSA is independently associated with diastolic dysfunction in patients with classical risk factors for diastolic dysfunction.

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Section: Osa and Diastolic Dysfunctionsupporting

confidence: 71%

Section: Osa and Diastolic Dysfunctionmentioning

confidence: 99%

Impact of obstructive sleep apnoea on diastolic function

et al. 2012

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“…OSA also has been noted in Ͼ50% of heart failure patients with preserved systolic function. 172 Three months of CPAP was reported to attenuate abnormalities in diastolic function, 123 suggesting a potential etiologic role of OSA in diastolic heart failure.…”

Section: Prevalence Of Osa In Heart Failurementioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…In addition, increasing age is an independent cause of diastolic dysfunction [20] and is associated with greater prevalence of central and obstructive sleep apnoea [31]. Secondly, CHAN et al [32] observed that 35% of patients who had recovered from acute pulmonary oedema secondary solely to left-ventricular diastolic dysfunction had obstructive sleep apnoea, and a further 20% had nonhypercapnic CSA. Finally, severe CSA has been reported in f29% of patients with primary pulmonary hypertension, with the speculative mechanism being attributed to pulmonary vagal afferent-nerve stimulation [15].…”

Section: Discussionmentioning

confidence: 99%

Cardiac diastolic function and hypercapnic ventilatory responses in central sleep apnoea

Solin

Jackson²,

Roebuck³

et al. 2002

European Respiratory Journal

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Hyperventilation is the key factor contributing to the development of idiopathic nonhypercapnic central sleep apnoea (ICSA), where left ventricular systolic function is normal. ICSA is reported to occur in 20% of patients with left ventricular diastolic dysfunction, in whom elevated pulmonary vascular pressures and resultant increased pulmonary vagal afferent traffic may contribute to hyperventilation. The contribution of the two potential mechanisms responsible for the hyperventilation seen in the following ICSA was measured: 1) left ventricular diastolic dysfunction-induced pulmonary hypertension; and 2) increased peripheral and central hypercapnic ventilatory responses (HCVR).The pulmonary artery pressure, left ventricular diastolic function and chemosensitivity to hypercapnia were measured during wakefulness in 16 subjects with ICSA.All subjects had systolic pulmonary artery pressures v3.99 kPa (v30 mmHg) and only four had diastolic dysfunction. All subjects had elevated peripheral and central HCVR compared with historical normal control subjects. Diastolic dysfunction correlated with increasing age but not with HCVR or markers of central sleep apnoea severity.Idiopathic nonhypercapnic central sleep apnoea is likely to be dependent upon raised hypercapnic ventilatory responses, and not pulmonary hypertension due to left ventricular diastolic dysfunction. Eur Respir J 2002; 20: 717-723.

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Prevalence of Sleep-Disordered Breathing in Diastolic Heart Failure

Cited by 209 publications

References 25 publications

Impact of obstructive sleep apnoea on diastolic function

Impact of obstructive sleep apnoea on diastolic function

Sleep Apnea and Cardiovascular Disease

Cardiac diastolic function and hypercapnic ventilatory responses in central sleep apnoea

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