Correlation between obstructive sleep apnea with heart failure with preserved ejection fraction
Abstract
Context: Heart failure with preserved ejection fraction is a common condition in general practice. It is a disease with many causes and associations. One of frequently found causes is obstructive sleep apnea.
Objective: To study the association between the obstructive sleep apnea and the cardiovascular system, leading to heart failure
Materials and Methods: The research articles, textbooks, and relevant previous studies were reviewed. Pathophysiology and the association between the Heart failure with preserved ejection fraction (HFpEF) and Obstructive sleep apnea (OSA) were summarized.
Results: Obstructive sleep apnea has a negative impact on cardiovascular function. The mechanisms were included alteration of intracardiac pressure, Hypoxia, Hypercapnia,
sympathetic activation, and inflammation. These can lead to Heart failure with preserved ejection fraction (HFpEF).
Conclusion: The association between the obstructive sleep apnea and the cardiovascular system is that it stimulates the sympathetic nervous system, causing inflammatory process of the body, myocardial ischemia, atrial fibrillation, and intrathoracic pressure swings. These
mechanisms ultimately cause heart failure.
References
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology. Developed with the special contribution of the Heart Failure Association (HFA) of The ESC. Eur J Heart. 2016; 37: 2129-200.
Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006; 355: 251-9.
Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006; 355: 260-69.
Zile MR, Gaasch WH, Anand IS, Haass M, Little WC, et al. Mode of death in patients with heart failure and a preserved ejection fraction: Result from the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial. Circulation. 2010; 121: 1393-405.
Michael R. Zile and William C. Little. Heart Failure with a Preserved Ejection Fraction. In Braunwald’s heart disease : a Textbook of cardiovascular medicine. Edited by Douglas P. Zipes, Peter Libby, Robert O. Bonow , et al. pp. 557-569. Philadelphia: Elsevier saunders; 2015.
Vest AR, Heneghan HM, Schauer PR, Young JB. Surgical management of obesity and the relationship to cardiovascular disease. Circulation. 2013; 127: 945-59.
Lam CS, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM. Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study. J Am Coll Cardiol. 2009; 53: 1119-26.
Ohara T, Ohte N, Little WC. Pulmonary hypertensionin heart failure with preserved left
ventricular ejection fraction: Diagnosis and management. Curr Opin cardiol. 2012; 27: 281-
Micha T Maeder, Otto D Schoch, Hans Rickli. A clinical approach to obstructive sleep apnea as a risk factor for cardiovascular disease. Vascular Health and Risk Management. 2016; 12: 85–103.
The Royal College of Otolaryngologists-Head and Neck Surgeons of Thailand. Guideline for development of diagnosis and treatment of snoring and obstructive sleep apnea in Thailand for adult 2017. Retrieved July 28, 2017, from https://www.rcot.org/data_detail.php?op=activity&id=77.
American Academy of Sleep Medicine. International classification of sleep disorders. 3rded. Darien, IL: American Academy of Sleep Medicine; 2014.
Tkacova R, Rankin F, Fitzgerald FS, Floras JS, Bradley TD. Effects of continuous positive airway pressure on obstructive sleep apnea and left ventricular afterload in patients with heart failure. Circulation. 1998; 98: 2269–75.
Virend K. Somers. Sleep Apnea and Cardiovascular Disease. In Braunwald’s heart disease : a Textbook of cardiovascular medicine. Edited by Douglas P. Zipes, Peter Libby, Robert O. Bonow , et al. pp. 1703-1708. Philadelphia: Elsevier saunders: 2015.
Otto ME, Belohlavek M, Romero-Corral A, Gami AS, Gilman G, Svatikova A, et al. Comparison of cardiac structural and functional changes in obese otherwise healthy adults with versus without obstructive sleep apnea. Am J Cardiol. 2007; 99: 1298-302.
Ferreira S, Marinho A, Patacho M, Santa-Clara E, Carrondo C, Winck J, et al. Prevalence and characteristics of sleep apnoea in patients with stable heart failure: results from a heart failure clinic. BMC Pulm Med. 2010; 10: 9.
Zhao ZH, Sullivan C, Liu ZH, Luo Q, Xiong CM, Ni XH, et al. Prevalence and clinical characteristics of sleep apnea in Chinese patients with heart failure. Int J Cardiol. 2007; 118: 122-3.
Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Töpfer V. Sleep disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail. 2007; 9: 251–7.
Javaheri S, Caref EB, Chen E, Tong KB, Abraham WT. Sleep apnea testing and outcomes in a large cohort of Medicare beneficiaries with newly diagnosed heart failure. Am J Respir Crit Care Med. 2011; 183: 539–46.
Bitter T, Faber L, Hering D, Langer C, Horstkotte D, Oldenburg O. Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction. Eur J Heart Fail. 2009; 11: 602-8.
Brenner S, Angermann C, Jany B, Ertl G, Störk S. Sleep-disordered breathing and heart failure a dangerous liaison. Trends Cardiovasc Med. 2008; 18: 240-7.
Sleep society of Thailand. Clinical recommendation for diagnosis and management of obstructive sleep apnea in Thailand for adults 2018. 1st edition. Bangkok: Beyond enterprise company limited; 2018.
Oldenburg O. Cheyne-stokes respiration in chronic heart failure. Treatment with adaptive servoventilation therapy. Circ J. 2012; 76: 2305–17.
Lenique F, Habis M, Lofaso F, Dubois-Randé JL, Harf A, Brochard L. Ventilatory and hemodynamic effects of continuous positive airway pressure in left heart failure. Am J Respir Crit Care Med. 1997; 155: 500-5.
Tkacova R, Rankin F, Fitzgerald FS, Floras JS, Bradley TD. Effects of continuous positive airway pressure on obstructive sleep apnea and left ventricular afterload in patients with heart failure. Circulation. 1998; 98: 2269-75.
Kaye DM, Mansfield D, Aggarwal A, Naughton MT, Esler MD. Acute effects of continuous positive airway pressure on cardiac sympathetic tone in congestive heart failure. Circulation. 2001; 103: 2336-8.
Naughton MT, Benard DC, Liu PP, Rutherford R, Rankin F, Bradley TD. Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med. 1995; 152: 473-9.
Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol. 2005; 45: 2008-11.
Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, et al. American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology; American Heart Association Stroke Council; American Heart Association Council on Cardiovascular Nursing; American College of Cardiology Foundation. Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation. 2008; 118: 1080-111.
Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009; 373: 82-93.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Burapha Journal of Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
