Journal ArticleDOI
Sleep-disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients.
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Evaluation of the prevalence and nature of sleep‐disordered breathing in patients with symptomatic chronic heart failure receiving therapy according to current guidelines finds that SDB is more common in women than in men.Abstract:
Aim: Evaluation of the prevalence and nature of sleep-disordered breathing (SDB) in patients with symptomatic chronic heart failure (CHF) receiving therapy according to current guidelines. Methods and results: We prospectively screened 700 patients with CHF (NYHA class ≥II, LV-EF ≤40%) for SDB using cardiorespiratory polygraphy (Embletta™). Furthermore, echocardiography, cardiopulmonary exercise and 6-min walk testing were performed. Medication included ACE-inhibitors and/or AT1-receptor blockers in at least 94%, diuretics in 87%, β-blockers in 85%, digitalis in 61% and spironolactone in 62% of patients. SDB was present in 76% of patients (40% central (CSA), 36% obstructive sleep apnoea (OSA)). CSA patients were more symptomatic (NYHA class 2.9±0.5 vs. no SDB 2.57±0.5 or OSA 2.57±0.5; pb0.05) and had a lower LV-EF (27.4±6.6% vs. 29.3±2.6%, pb0.05) than OSA patients. Oxygen uptake (VO2) was lowest in CSA patients: predicted peak VO2 57±16% vs. 64±18% in OSA and 63±17% in no SDB, pb0.05. 6-min walking distances were 331±111 m in CSA, 373±108 m in OSA and 377±118 m in no SDB (pb0.05). Conclusions: This study confirms the high prevalence of SDB, particularly CSA in CHF patients. CSA seems to be a marker of heart failure severity.read more
Citations
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Journal ArticleDOI
Pathophysiology of Sleep Apnea
TL;DR: This work reviews three types of major long-term sequelae to severe OSA and discusses future research into understanding the pathophysiology of sleep apnea as a basis for uncovering newer forms of treatment of both the ventilatory disorder and its multiple sequelae.
Journal ArticleDOI
Sleep Apnea and Cardiovascular Disease
Virend K. Somers,David P. White,Raouf S. Amin,William T. Abraham,Fernando Ferreira Costa,Antonio Culebras,Stephen R. Daniels,John S. Floras,Carl E. Hunt,Lyle J. Olson,Thomas G. Pickering,Richard O. Russell,Mary Woo,Terry Young +13 more
TL;DR: The American Heart Association/American College of Cardiology Scientific Statement on Sleep Apnea and Cardiovascular Disease as discussed by the authors highlights concepts and evidence important to understanding the interactions between sleep apnea and cardiovascular disease, with particular attention to more recent advances in patient-oriented research.
Journal ArticleDOI
Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure
Martin R. Cowie,Holger Woehrle,Karl Wegscheider,Christiane E. Angermann,Marie Pia d'Ortho,Erland Erdmann,Patrick Levy,Anita K. Simonds,Virend K. Somers,Faiez Zannad,Helmut Teschler +10 more
TL;DR: Adaptive servo-ventilation had no significant effect on the primary end point in patients who had heart failure with reduced ejection fraction and predominantly central sleep apnea, but all-cause and cardiovascular mortality were both increased with this therapy.
Journal ArticleDOI
Epidemiology of Obstructive Sleep Apnea: a Population-based Perspective.
TL;DR: This review summarizes the recent literature on the epidemiology of adult obstructive sleep apnea from various population-based studies and focuses on the economic healthcare burden of OSA and the importance of recognizing the largely undiagnosed OSA population.
Journal ArticleDOI
JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure ― Digest Version ―
Hiroyuki Tsutsui,Mitsuaki Isobe,Hiroshi Ito,Ken Okumura,Minoru Ono,Masafumi Kitakaze,Koichiro Kinugawa,Yasuki Kihara,Yoichi Goto,Issei Komuro,Yoshikatsu Saiki,Yoshihiko Saito,Yasushi Sakata,Naoki Sato,Yoshiki Sawa,Akira Shiose,Wataru Shimizu,Hiroaki Shimokawa,Yoshihiko Seino,Koichi Node,Taiki Higo,Atsushi Hirayama,Miyuki Makaya,Tohru Masuyama,Toyoaki Murohara,Shin-ichi Momomura,Masafumi Yano,Kenji Yamazaki,Kazuhiro Yamamoto,Tsutomu Yoshikawa,Michihiro Yoshimura,Masatoshi Akiyama,Toshihisa Anzai,Shiro Ishihara,Takayuki Inomata,Teruhiko Imamura,Yu-ki Iwasaki,Tomohito Ohtani,Katsuya Onishi,Takatoshi Kasai,Mahoto Kato,Makoto Kawai,Yoshiharu Kinugasa,Shintaro Kinugawa,Toru Kuratani,Shigeki Kobayashi,Yasuhiko Sakata,Atsushi Tanaka,Koichi Toda,Takashi Noda,Kotaro Nochioka,Masaru Hatano,Takayuki Hidaka,Takeo Fujino,Shigeru Makita,Osamu Yamaguchi,Uichi Ikeda,Takeshi Kimura,Shun Kohsaka,Masami Kosuge,Masakazu Yamagishi,Akira Yamashina +61 more
TL;DR: This English language document is a revised digest version of Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure (JCS 2017/JHFS 2017) reported at the Japanese Circulation Society Joint Working Groups performed in 2017.
References
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Journal ArticleDOI
Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology.
Karl Swedberg,John G.F. Cleland,Henry J. Dargie,Helmut Drexler,Ferenc Follath,Michel Komajda,Luigi Tavazzi,Otto A. Smiseth,Antonello Gavazzi,Axel Haverich,Arno W. Hoes,Tiny Jaarsma,Jerzy Korewicki,Samuel Lévy,Cecilia Linde,José-Luis López-Sendón,Markku S. Nieminen,Luc Pierard,Willem J. Remme +18 more
TL;DR: Recent surveys of Guidelines and Expert Consensus Documents published in peer-reviewed journals between 1985 and 1998 have shown that methodological standards were not complied with in the vast majority of cases.
Journal ArticleDOI
The effect of cardiac resynchronization on morbidity and mortality in heart failure
John G.F. Cleland,Jean-Claude Daubert,Erland Erdmann,Nick Freemantle,Daniel Gras,Lukas Kappenberger,Luigi Tavazzi +6 more
TL;DR: Cardiac resynchronization has been shown to reduce symptoms and improve left ventricular function in patients with heart failure due to systolic dysfunction and cardiac dyssynchrony.
Journal ArticleDOI
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult
Sharon A. Hunt,William T. Abraham,Marshall H. Chin,Arthur M. Feldman,Gary S. Francis,Theodore G. Ganiats,Mariell Jessup,Marvin A. Konstam,Donna Mancini,Keith Michl,John A. Oates,Peter S. Rahko,Marc A. Silver,Lynne W. Stevenson,Clyde W. Yancy,Elliott M. Antman,Sidney C. Smith,Cynthia D. Adams,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Alice K. Jacobs,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Barbara Riegel +27 more
TL;DR: This document summarizes current capabilities, research and operational priorities, and plans for further studies that were established at the 2015 USGS workshop on quantitative hazard assessments of earthquake-triggered landsliding and liquefaction.
Journal Article
Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research
W. Ward Flemons,Daniel J. Buysse,Susan Redline,A. Oack,Kingman P. Strohl,John R. Wheatley,Terry Young,Neil J. Douglas,Patrick Levy,W. McNicolas,John A. Fleetham,David P. White,W. Schmidt-Nowarra,D. Carley,J. Romaniuk +14 more
Journal ArticleDOI
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial
TL;DR: Beta-blocker therapy had benefits for survival in stable heart-failure patients and should not be extrapolated to patients with severe class IV symptoms and recent instability because safety and efficacy has not been established in these patients.