Sleep disordered breathing and enlargement of the right heart after myocardial infarction

Büchner, Stefan; Eglseer, Michael; Debl, Kurt; Hetzenecker, Andrea; Luchner, Andreas; Hüsser, Oliver; Stroszczynski, Christian; Hamer, Okka W.; Fellner, Claudia; Zeman, Florian; Pfeifer, Michael; Arzt, Michael

doi:10.1183/09031936.00057014

Cited by 28 publications

(21 citation statements)

References 30 publications

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“…Thus, SDB may contribute to enlargement of the right heart after acute MI. 80 Whether treatment of SDB with adaptive servo-ventilation (ASV) early after MI increases salvaged myocardium and cardiac function is currently being evaluated in a multicenter randomized controlled trial (Treatment of sleep apnea Early After Myocardial infarction with Adaptive Servo-Ventilation, TEAM-ASV I, NCT02093377).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Sleep-Disordered Breathing and Coronary Artery Disease

Arzt

Hetzenecker

Steiner

et al. 2015

Canadian Journal of Cardiology

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Sleep-Disordered Breathing and Coronary Artery Disease

Arzt

Hetzenecker

Steiner

et al. 2015

Canadian Journal of Cardiology

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“…In addition, the increase in platelet activity and aggregation, as well as the reduction in fibrinolytic activity, together with the increase in fibrinogen in patients with OSA may favour coronary artery thrombosis, a pathogenic mechanism of ACS. 33,34 The risk of recurrence of cardiovascular events after a heart attack is higher in patients with excessive daytime sleepiness, regardless of AHI and oxygen desaturation. 35 OSA may induce or worsen an existing heart failure via various mechanisms regardless of the presence or absence of hypertension.…”

Section: Hypertension and Cerebrovascular Diseasementioning

confidence: 99%

Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk

et al. 2020

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Obstructive sleep apnoea (OSA) syndrome is characterised by the presence of apnoea or obstructive hypopnoea during sleep, accompanied by hypoxia. It is estimated that the syndrome affects approximately 10% of men and 15% of women. Diagnosis and treatment rates have increased in recent years, but the condition remains undiagnosed in a high percentage of patients. Recent evidence suggests that OSA may increase the risk of cardiovascular disease. The relationship between OSA and cardiovascular disease can be explained, at least in part, by the coexistence of cardiovascular risk factors in the two pathologies, such as age, overweight, smoking and sedentary lifestyle. However, OSA has been independently associated with the risk of developing hypertension, cerebrovascular disease, ischaemic heart disease, heart failure and arrhythmias. Clinical trials that have evaluated the efficacy of continuous positive airway pressure (CPAP) treatment in primary and secondary cardiovascular prevention have not demonstrated a significant reduction in the incidence or recurrence of cardiovascular events. This article analyses the relationship between OSA and cardiovascular risk and discusses recent clinical trials on the efficacy of CPAP in primary and secondary cardiovascular prevention.

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“…Ongoing studies (ISAACC [140] and TEAM-ASV) will determine the role of early PAP therapy after acute coronary syndrome, based on documented associations between SDB and infarct size/myocardial salvage [141] and right heart enlargement [142] after acute myocardial infarction.…”

Section: Effects Of Treatmentmentioning

confidence: 99%

Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management

Farrell

Richards

2017

J Transl Med

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Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status. Severe OSA increases the risk of arrhythmias, including atrial fibrillation, influences risk management in stroke, and is highly prevalent in patients with type 2 diabetes. Effective treatment with CPAP improves the success of antiarrhythmic interventions, improves outcomes in stroke and reduces hyperglycemia in diabetes. Patients with coronary artery disease also have a high prevalence of SDB, which is independently associated with worse outcomes. The role of CPAP for secondary cardiovascular prevention remains to be determined. Data from large, well-conducted clinical trials have shown that noninvasive ventilation, targeted to markedly reduce hypercapnia, significantly improves survival and reduces readmission in stable hypercapnic chronic obstructive pulmonary disease. The association of SDB with chronic diseases contributes to the high healthcare costs incurred by SDB patients. SDB also has an important negative impact on quality of life, which is reversed by CPAP treatment. The high prevalence of SDB, and its association with diseases that cause significant morbidity and mortality, suggest that the diagnosis and management of SDB is an important therapeutic goal. First, adherent CPAP treatment significantly improves the quality of life of all patients with SDB; second, it eliminates the negative impact of untreated SDB on any associated chronic diseases; and third, it significantly reduces the increased costs of all hospital and medical services directly associated with untreated SDB. In short, the recognition and treatment of SDB is vital for the continued health and wellbeing of individual patients with SDB.

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Sleep disordered breathing and enlargement of the right heart after myocardial infarction

Cited by 28 publications

References 30 publications

Sleep-Disordered Breathing and Coronary Artery Disease

Sleep-Disordered Breathing and Coronary Artery Disease

Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk

Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management

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