Role of chemosensitivity: Possible pathophysiological mediator of obstructive sleep apnea and type 2 diabetes

Dai, Lu; Wang, Xiaona; Xiao, Yi

doi:10.1016/j.sleep.2022.12.004

Cited by 3 publications

(2 citation statements)

References 79 publications

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“…This pre-test probability can be further modified by applying other known clinical risk markers such as smoking, hypertension diabetes, dyslipidemia, family history of CVD, resting ECG changes (Q wave or ST-segment/T wave changes), LV dysfunction suggestive of CAD, abnormal excersice ECG and coronary Calcium by CT. This can be correspondingly diminished or augmented to give a clinical likelihood ratio for obstructive CAD (Boivin-Proulx et al, 2023;Dai et al, 2024;Rinaldi et al, 2024;Sands & Edwards, 2023).…”

Section: Introductionmentioning

confidence: 99%

Characteristic of Clinical Likelihood Chronic Coronary Syndrome patients with Significant Coronary Lesion in RSUP dr. Mohammad Hoesin Palembang

Qonitah,

P. Pratama,

Puspita

2024

AJESH

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Chronic coronary syndrome (CCS) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. Significant Coronary artery disease (CAD) is defined by invasive coronary angiography as >50% stenosis of the left main stem, >70% stenosis in a major coronary vessel, or 30% to 70% stenosis with fractional flow reserve ?0.8. This study aimed to identify the characteristics of clinical likelihood CCS patients with site of significant coronary lesion based on pre-test probability (PTP) from demographic characteristics; risk factors; laboratory and echocardiography findings. This is a retrospective cohort study. We reviewed 60 medical records of clinical likelihood chronic coronary syndrome patients with positive inducible ischemia area from dobutamine stress echocardiography and significant CAD lesion from coronary angiography. The incidence of significant CAD in this population was 56.1%. There was a significant relationship between age > 65 years with the incidence of significant LAD lesion (23.3%, p = 0.019); significant LCx lesion (20%, p = 0.043). There was a significant relationship between PTP score ? 16% with significant LAD lesion (55.0%, p = 0.001); significant LCx lesion (45.0%, p = 0.031); and significant RCA lesion (40.0%, p = 0.050). Patients with age > 65 years have a higher incidence of significant LAD and LCx lesions. Patients with pre-test probability score ? 16% have a higher incidence of significant lesions across coronary branches, predominantly in the LAD.

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Section: Introductionmentioning

confidence: 99%

Characteristic of Clinical Likelihood Chronic Coronary Syndrome patients with Significant Coronary Lesion in RSUP dr. Mohammad Hoesin Palembang

Qonitah,

P. Pratama,

Puspita

2024

AJESH

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“…Ablation therapy, such as radiofrequency (RF) or cryoballoon (Cryo) ablation, is an effective strategy for rhythm control for drug-refractory and symptomatic AF patients (2). Obstructive sleep apnea (OSA), a growingly common form of sleep-disordered breathing, is characterized by the repeated upper airway collapse during sleep, subsequently causing to sleep fragmentation and oxygen desaturation (3).…”

Section: Introductionmentioning

confidence: 99%

Continuous positive airway pressure therapy might be an effective strategy on reduction of atrial fibrillation recurrence after ablation in patients with obstructive sleep apnea: insights from the pooled studies

Li,

He,

Ding

et al. 2023

Front. Neurol.

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BackgroundObstructive sleep apnea (OSA) is an independent and modifiable risk factor in the initiation and maintenance of atrial fibrillation (AF). However, the effective of the continuous positive airway pressure (CPAP) on AF patients with OSA after ablation is elusive.MethodsCochrane Library, PubMed, Embase, and Web of Science were systematically searched up to February 1, 2023. Studies comprising the AF recurrence rate between the CPAP therapy group and non-CPAP therapy group for the AF patients with OSA were included. Meanwhile, trial sequential analysis (TSA) was conducted to adjust the lower statistical power and random error in this study. Subgroup analysis identified the potential determinants for the AF recurrence rate with CPAP therapy.ResultsA total of eight studies including 1,231 AF patients with OSA were eligible. Compared with non-CPAP treatment group, CPAP treatment group was statistically associated with a lower AF recurrence rate (risk ratio [RR], 0.58; p = 0.000). TSA indicated the firm evidence favoring CPAP group for AF recurrence risk. Three significant intervention-covariate interactions for AF recurrence was identified, including study design, non-paroxysmal AF (PAF) proportion, and CPAP treatment strategy.ConclusionOur study suggests that CPAP therapy might be an effective strategy on reducing AF recurrence post-ablation for AF patients with OSA. The CPAP treatment strategy and the non-PAF proportion might be the possible determinants on AF recurrence for AF patients with OSA after ablation.Clinical trial registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023398588, identifier (CRD42023398588).

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Nocturnal urination is associated with the presence of higher ventilatory chemosensitivity in patients with obstructive sleep apnea

Dai,

Guo,

Wang

et al. 2024

Sleep Breath

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Purpose Chemosensitivity is an essential part of the pathophysiological mechanisms of obstructive sleep apnea (OSA). This study aims to use the rebreathing method to assess hypercapnic ventilatory response (HCVR) and analyze the association between chemosensitivity and certain symptoms in patients with OSA. Methods A total of 104 male patients with diagnosed OSA were enrolled. The HCVR was assessed using rebreathing methods under hypoxia exposure to reflect the overall chemosensitivity. Univariate and multivariate linear regression were used to explore the association with chemosensitivity. Participants were enrolled in the cluster analysis using certain symptoms, basic characteristics, and polysomnographic indices. Results At similar baseline values, the high chemosensitivity group (n = 39) demonstrated more severe levels of OSA and nocturnal hypoxia than the low chemosensitivity group (n = 65). After screening the possible associated factors, nocturnal urination, rather than OSA severity, was found to be positively associated with the level of chemosensitivity. Cluster analysis revealed three distinct groups: Cluster 1 (n = 32, 34.0%) held younger, obese individuals with nocturnal urination, elevated chemosensitivity level, and very severe OSA; Cluster 2 (41, 43.6%) included middle-aged overweighted patients with nocturnal urination, increased chemosensitivity level, but moderate-severe OSA; and Cluster 3 (n = 21, 22.3%) contained middle-aged overweighted patients without nocturnal urination, with a lowered chemosensitivity level and only moderate OSA. Conclusion The presence of nocturnal urination in male patients with OSA may be a sign of higher levels of ventilatory chemosensitivity, requiring early therapy efforts independent of AHI levels.

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Role of chemosensitivity: Possible pathophysiological mediator of obstructive sleep apnea and type 2 diabetes

Cited by 3 publications

References 79 publications

Characteristic of Clinical Likelihood Chronic Coronary Syndrome patients with Significant Coronary Lesion in RSUP dr. Mohammad Hoesin Palembang

Characteristic of Clinical Likelihood Chronic Coronary Syndrome patients with Significant Coronary Lesion in RSUP dr. Mohammad Hoesin Palembang

Continuous positive airway pressure therapy might be an effective strategy on reduction of atrial fibrillation recurrence after ablation in patients with obstructive sleep apnea: insights from the pooled studies

Nocturnal urination is associated with the presence of higher ventilatory chemosensitivity in patients with obstructive sleep apnea

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