scholarly journals Obstructive Sleep Apnea Increases Sudden Cardiac Death in Incident Hemodialysis Patients

2018 ◽  
Vol 48 (2) ◽  
pp. 147-156 ◽  
Author(s):  
Eric S. Kerns ◽  
Esther D. Kim ◽  
Lucy A. Meoni ◽  
Stephen M. Sozio ◽  
Bernard G. Jaar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Cardiovascular Mortality ◽  
Cardiac Death ◽  
Hemodialysis Patients ◽  
Obstructive Sleep ◽  
All Cause Mortality

Background: Mortality in end-stage renal disease (ESRD) occurs predominantly from cardiovascular disease (CVD) and sudden cardiac death (SCD). Obstructive sleep apnea (OSA) is characterized by periodic airflow limitation associated with sleep arousal and oxygen desaturation and is prevalent in patients with ESRD. Whether OSA increases the risk for SCD, cardiovascular and all-cause mortality among hemodialysis patients remains unknown. Methods: In a prospective cohort of 558 incident hemodialysis patients, we examined the association of OSA with all-cause mortality, cardiovascular mortality, and SCD using Cox proportional hazards models controlling for traditional CVD risk factors. Results: Sixty-six incident hemodialysis patients (12%) had OSA. Mean age (56 years) and percentage of males (56%) were identical in OSA and no-OSA groups. Fewer African Americans had OSA than non-African Americans (9 vs. 18%, respectively). Participants with OSA had higher body-mass index, Charlson comorbidity score, and left ventricular mass index and greater prevalence of diabetes and coronary artery disease. During 1,080 person-years of follow-up, 104 deaths occurred, 29% of which were cardiovascular. OSA was associated with a higher risk of all-cause mortality (HR 1.90 [95% CI 1.04–3.46]) and cardiovascular mortality (HR 3.62 [95% CI 1.36–9.66]) after adjusting for demographics and body-mass index. OSA was associated with a higher risk of SCD after adjusting for demographics (HR 3.28 [95% CI 1.12–9.57]) and multiple cardiovascular risk factors. Conclusions: Incident hemodialysis patients with OSA are at increased risk of all-cause and cardiovascular mortality and SCD. Future studies should assess the impact of screening for OSA and OSA-targeted interventions on mortality in ESRD.

scholarly journals Clues to the Pathophysiology of Sudden Cardiac Death in Obstructive Sleep Apnea

Cardiology ◽  
2018 ◽  
Vol 140 (4) ◽  
pp. 247-253 ◽  
Author(s):  
Tatyana Olegovna Brodovskaya ◽  
Irina Fedorovna Grishina ◽  
Tatiana Fedorovna Peretolchina ◽  
Olga Georgievna Solenskaia ◽  
Olga Petrovna Kovtun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Intrathoracic Pressure ◽  
National Society ◽  
Obstructive Sleep ◽  
Pressure Changes ◽  
The Impact

Background: Risk assessment of sudden cardiac death (SCD) is multifactorial and complex, especially among individuals without established cardiovascular disease. There are insufficiently investigated conditions that can affect arrhythmogenesis. One such condition is obstructive sleep apnea (OSA) syndrome, which is not on the list of risk factors of the Russian National Society of Arrhythmology. Objective: The aim of this review article is to discuss clues to the pathophysiology of SCD in OSA subjects. Methods: We searched the literature for data reporting the impact of apnea on arrhythmogenesis. The preferred languages were English and Russian. The most important clinical reports, as well as biochemistry and pathophysiology guides, were selected for inclusion in the review. Results: It was clearly observed in the searched literature that OSA is the crucial aspect of arrhythmogenesis. Among the clues are intermittent nocturnal hypoxia, reactive oxygen species, cardiomyocyte metabolism disturbances, myocardial electric heterogeneity, and intrathoracic pressure changes. Conclusion: This review emphasizes the importance of the inclusion of OSA in the list of risk factors of the Russian National Society of Arrhythmology.

Obstructive Sleep Apnea Increases the Risk of Sudden Cardiac Death: A Longitudinal Study of 10,701 Adults

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Apoor Gami
Keyword(s):  
Obstructive Sleep Apnea ◽  
Longitudinal Study ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Mayo Clinic ◽  
Cardiac Death ◽  
Obstructive Sleep

Abstract 505 Apoor S Gami, Eric J Olson, Win K Shen, R Scott Wright, Karla V Ballman, David O Hodge, Regina M Herges, Daniel E Howard, Virend K Somers, Mayo Clinic, Rochester, MN Apoor Gami, 2008 Finalist and Presenting Author

scholarly journals Obstructive Sleep Apnea and Sudden Cardiac Death: Is the Landscape Clear?

Cardiology ◽  
2018 ◽  
Vol 140 (4) ◽  
pp. 254-256 ◽  
Author(s):  
Emmanuel N. Simantirakis ◽  
Panteleimon E. Papakonstantinou
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Obstructive Sleep

Effect of Obstructive Sleep Apnea on QT Dispersion: A Potential Mechanism of Sudden Cardiac Death

Cardiology ◽  
2011 ◽  
Vol 118 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Louis Voigt ◽  
Salman A. Haq ◽  
Cristina A. Mitre ◽  
Gerard Lombardo ◽  
John Kassotis
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Qt Dispersion ◽  
Potential Mechanism ◽  
Obstructive Sleep

scholarly journals Obstructive Sleep Apnea and the Risk of Sudden Cardiac Death

2013 ◽  
Vol 62 (7) ◽  
pp. 610-616 ◽  
Author(s):  
Apoor S. Gami ◽  
Eric J. Olson ◽  
Win K. Shen ◽  
R. Scott Wright ◽  
Karla V. Ballman ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Obstructive Sleep

scholarly journals Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1485
Author(s):  
Marta Stelmach-Mardas ◽  
Beata Brajer-Luftmann ◽  
Marta Kuśnierczak ◽  
Halina Batura-Gabryel ◽  
Tomasz Piorunek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Metabolic Risk ◽  
Index Reduction ◽  
Obstructive Sleep

Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea–hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea–hypopnea index (−2.83/h; 95% CI: −4.24, −1.41), total cholesterol (−0.12 mmol/L; 95% CI: −0.22, −0.01), triglycerides (−0.24 mmol/L; 95% CI: −0.46, −0.02), fasting insulin (−7.3 pmol/L; 95% CI: −11.5, −3.1), systolic (−1.86 mmHg; 95% CI: −3.57, −0.15) and diastolic blood pressure (−2.07 mmHg; 95% CI: −3.79, −0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.

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