Obstructive sleep apnea syndrome and cardiovascular events

Cover Page

Cite item

Full Text

Abstract

The epidemiological and randomized clinical studies show that obstructive sleep apnea syndrome (OSA) is a common, risk factor of cardiovascular disease which can be treated. There are numerous studies, confirming the negative impact of OSA on cardiovascular morbidity and mortality. The present review focuses on new results arguing for the strong link between OSA and chronic ischemic heart disease, acute coronary syndrome, and stroke, as well. The article deals with the studies, evaluating the impact of CPAP therapy (CPAP - continuous positive airway pressure) on reduction of cardiovascular mortality and incidence of cardiovascular events among cardiac patients with OSA. OSA treatment using CPAP therapy is associated with the reduction of fatal and non-fatal cardiovascular events. At the same time, there are no clear evidence-based recommendations concerning the application of CPAP therapy in asymptomatic OSA patients worked out.

About the authors

A. Yu Litvin

A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation

Email: alelitvin@yandex.ru
д-р мед. наук, рук. лаб. апноэ сна, отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a

O. O Mikhailova

A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation

аспирант отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a

E. M Elfimova

A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation

лаборант-исследователь, лаб. апноэ сна, отд. гипертонии ИКК им. А.Л.Мясникова ФГБУ РКНПК 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a

I. E Chazova

A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation

Email: c34h@yandex.ru
чл.-кор. РАН, д-р мед. наук, проф., и.о. ген. дир. ФГБУ РКНПК, дир. ИКК им. А.Л.Мясникова ФГБУ РКНПК 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a

References

  1. Yumino D, Wang H, Floras J.S et al. Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction. J Card Fail 2009; 15: 279-85.
  2. Bassetti C.L, Milanova M, Gugger M. Sleep - disordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long - term clinical outcome. Stroke 2006; 37: 967-72.
  3. Logan A.G, Perlikowski S.M, Mente A et al. High prevalence of unrecognized sleep apnoea in drug - resistant hypertension. J Hypertens 2001; 19: 2271-7.
  4. Mann G.C.V. Obstructive sleep apnea. Diagnosis and treatment. Med Clin North Am 1996; 80: 803-20.
  5. Deegan P.C, Mc Nicholas W.T. Pathophysiology of obstructive sleep apnoea. Eur Respir J 1995; 8: 1161-78.
  6. Johns M.V. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleeping Scale. Chest 1993; 103: 30-6.
  7. Nieto F.J, Young T.B, Lind B.K et al. Association of sleep - disordered breathing, sleep apnea, and hypertension in a large community - based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-36.
  8. Peppard P.E, Young T, Palta M, Skatrud J. Prospective study of the association between sleep - disordered breathing and hypertension. N Engl J Med 2000; 342: 1378-84.
  9. Marin J.M, Corrizo S.J, Vicente E, Agusti A.G.N. Long - term cardiovascular outcomes in men with obstructive sleep apnoea - hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365: 1046-53.
  10. Mehra R, Benjamin E.J, Shahar E et al. Association of nocturnal arrhythmias with sleep - disordered breathing: the Sleep Heart Health Study. Am J Respir Crit Care Med 2006; 173: 910-6.
  11. Yaggi H.K, Concato J, Kernan W.N et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-41.
  12. Somers V.K, White D.P, Amin R, et al. 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. J Am Coll Cardiol 2008; 52: 686-717.
  13. Bradley T.D, Floras J.S. Obstructive sleep apnoea and its cardiovascular consequences. Lancet 2009; 373: 82-93.
  14. Kasai T, Bradley T.D. Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol 2011; 57: 119-27.
  15. Milleron O, Pilliere R, Foucher A et al. Benefits of obstructive sleep apnoea treatment in coronary artery disease: a long - term follow - up study. Eur Heart J 2004; 25: 728-34.
  16. Cassar A, Morgenthaler T.I, Lennon R.J et al. Treatment of obstructive sleep apnea is associated with decreased cardiac death after percutaneous coronary intervention. J Am Coll Cardiol 2007; 50: 1310-4.
  17. Ryan C.M, Bayley M, Green R et al. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea. Stroke 2011; 42: 1062-7.
  18. Punjabi N.M. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-43.
  19. Mooe T, Rabben T, Wiklund U et al. Sleep - disordered breathing in men with coronary artery disease. Chest 1996; 109 (3): 659-63.
  20. De Olazabal J.R, Miller M.J, Cook W.R, Mithoefer J.C. Disordered breathing and hypoxia during sleep in coronary artery disease. Chest 1982; 82 (5): 548-52.
  21. Sebel J, Kolenda D. Praђvalenz der obstruktiven Schlafapnoe bei Patienten mit koronarer Herzerkrankung. Herz Kreis 1995; 27: 153-8.
  22. Andreas S, Schulz R, Werner G.S, Kreuzer H. Prevalence of obstructive sleep apnoea in patients with coronary artery disease. Coron Artery Dis 1996; 7 (7): 541-5.
  23. Peker Y, Kraiczi H, Hedner J et al. An independent association between obstructive sleep apnoea and coronary artery disease. Eur Respir J 1999; 14 (1): 179-84.
  24. Koehler U, Schafer H. An independent association between obstructive sleep apnoea and coronary artery disease. Is obstructive sleep apnea (OSA) a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease (CHD)? Sleep 1996; 19 (4): 283-6.
  25. Schafer H, Koehler U, Ewig S et al. Obstructive sleep apnea as a risk marker in coronary artery disease. Cardiology 1999; 92 (2): 79-84.
  26. Sanner B, Sturm A, Konermann M. Coronary heart disease in patients with obstructive sleep apnea. Dtsch Med Wochenschr 1996; 121 (30): 931-5.
  27. Mooe T, Franklin K.A, Wiklund U et al. Sleep - disordered breathing and myocardial ischemia in patients with coronary artery disease. Chest 2000; 117 (6): 1597-602.
  28. Schafer H, Koehler U, Ploch T, Peter J.H. Sleep - related myocardial ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease. Chest 1997; 111 (2): 387-93.
  29. Shahar E, Whitney C.W, Redline S et al. Sleep - disordered breathing and cardiovascular disease: cross - sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001; 163: 19-25.
  30. Gottlieb D.J, Yenokyan G, Newman A.B et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 2010; 122: 352-60.
  31. Punjabi N.M, Caffo B.S, Goodwin J.L et al. Sleep - disordered breathing and mortality: A prospective cohort study. PLoS Med 2009; 6: e1000132.
  32. Shah N.A, Yaggi H.K, Concato J, Mohsenin V. Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death. Sleep Breath 2010; 14: 131-6.
  33. Yumino D, Tsurumi Y, Takagi A et al. Impact of obstructive sleep apnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome. Am J Cardiol 2007; 99: 26-30.
  34. Hanly P, Sasson Z, Zuberi N, Lunn K. ST-segment depression during sleep in obstructive sleep apnea. Am J Cardiol 1993; 71 (15): 1341-5.
  35. Alonso-Fernandez A, Garcia-Rio F, Racionero M.A et al. Cardiac rhythm disturbances and ST- segment depression episodes in patients with obstructive sleep apnea - hypopnea syndrome and its mechanisms. Chest 2005; 127 (1): 15-22.
  36. Andreas S, Hajak G, Natt P et al. ST-segmental changes and arrhythmias in obstructive sleep apnea. Pneumologie 1991; 45 (9): 720-4.
  37. Bradley T.D, Hall M.J, Ando S, Floras J.S. Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure. Chest 2001; 119: 1827-35.
  38. Bradley T.D, Tkacova R, Hall M.J et al. Augmented sympathetic neural response to simulated obstructive apnoea in human heart failure. Clin Sci (Lond) 2003; 104: 231-8.
  39. Peker Y, Hedner J, Norum J et al. Increased incidence of cardiovascular disease in middle - aged men with obstructive sleep apnea: a 7-year follow - up. Am J Respir Crit Care Med 2002; 166 (2): 159-65.
  40. Peker Y, Carlson J, Hedner J. Increased incidence of coronary artery disease in sleep apnoea: a long - term follow - up. Eur Respir J 2006; 28 (3): 596-602.
  41. Konecny T, Kuniyoshi F.A.S, Orban M et al. Under - diagnosis of sleep apnea in patients after acute myocardial infarction. J Am Coll Cardiol 2010; 56: 742-3.
  42. Hung J, Whitford E.G, Parsons R.W, Hillman D.R. Association of sleep apnoea with myocardial infarction in men. Lancet 1990; 336 (8710): 261-4.
  43. Junker-Neff A, Eberle R, Arnim T et al. Is there an association between the sleep apnea syndrome and the circadian peak of myocardial infarction in the morning hours? Dtsch Med Wochenschr 2005; 130 (49): 2818-22.
  44. Aboyans V, Cassat C, Lacroix P et al. Is the morning peak of acute myocardial infarction’s onset due to sleep - related breathing disorders? A prospective study. Cardiology 2000; 94 (3): 188-92.
  45. Koehler U, Trautmann M, Trautmann R et al. Does sleep apnea increase the risk of myocardial infarct during sleep? Z Kardiol 1999; 88 (6): 410-7.
  46. Somers V.K, Dyken M.E, Clary M.P, Abboud F.M. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995; 96 (4): 1897-904.
  47. Shah N, Redline S, Yaggi H.K et al. Obstructive sleep apnea and acute myocardial infarction severity: ischemic preconditioning? Sleep Breath 2013; 17 (2): 819-26.
  48. Franklin K.A, Nilsson J.B, Sahlin C, Naslund U. Sleep apnoea and nocturnal angina. Lancet 1995; 345: 1085-7.
  49. Doherty L.S, Kiely J.L, Swan V, Mc Nicholas W.T. Long - term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005; 127 (6): 2076-84.
  50. Young T, Palta M, Dempsey J et al. The occurrence of sleep - disordered breathing among middle - aged adults. N Engl J Med 1993; 328 (17): 1230-5.
  51. Young T, Shahar E, Nieto F.J et al. Predictors of sleep - disordered breathing in community - dwelling adults: the Sleep Heart Health Study. Arch Intern Med 2002; 162 (8): 893-900.
  52. Franklin K.A, Gislason T, Omenaas E et al. The inяuence of active and passive smoking on habitual snoring. Am J Respir Crit Care Med 2004; 170 (7): 799-803.
  53. Eisensehr I, Ehrenberg B.L, Noachtar S et al. Platelet activation, epinephrine, and blood pressure in obstructive sleep apnea syndrome. Neurology 1998; 51 (1): 188-95.
  54. Kohler U et al. Herzrhythmusstorungen bei Schlafapnoe. Erhohtes kardiovaskulares Risk durch nachtliche Arrhythmien? Fortschr Med 1998; 116 (16): 28-31.
  55. Friedlander A.H, Friedlander I.K, Yueh R, Littner M.R. The prevalence of carotid atheromas seen on panoramic radiographs of patients with obstructive sleep apnea and their relation to risk factors for atherosclerosis. J Oral Maxillofac Surg 1999; 57 (5): 516-21; discussion 521-2.
  56. Minoguchi K, Yokoe T, Tazaki T et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175: 612-7.
  57. Arzt M, Young T, Finn L et al. Association of sleep - disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med 2005; 172: 1447-51.
  58. Palomaki H, Partinen M, Erkinjuntti T, Kaste M. Snoring, sleep apnea syndrome, and stroke. Neurology 1992; 42 (Suppl. 6): 75-81.
  59. Partinen M, Palomaki H. Snoring and cerebral infarction. Lancet 1985; 2: 1325-6.
  60. Cho J.G, Witting P.K, Verma M et al. Tissue vibration induces carotid artery endothelial dysfunction: a mechanism linking snoring and carotid atherosclerosis? Sleep 2011; 34: 751-7.
  61. Redline S, Yenokyan G, Gottlieb D.J et al. Obstructive sleep apnea - hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010; 182: 269-77.
  62. Munoz R, Duran-Cantolla J, Martinez-Vila E et al. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke 2006; 37: 2317-21.
  63. Valham F, Mooe T, Rabben T et al. Increased risk of stroke in patients with coronary artery disease and sleep apnea: a 10-year follow - up. Circulation 2008; 118: 955-60.
  64. Netzer N, Werner P, Jochums I et al. Blood flow of the middle cerebral artery with sleep - disordered breathing: correlation with obstructive hypopneas. Stroke 1998; 29 (1): 87-93.
  65. Guilleminault C, Connolly S.J, Winkle R.A. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983; 52: 490-4.
  66. Mooe T, Gullsby S, Rabben T, Eriksson P. Sleep - disordered breathing: a novel predictor of atrial fibrillation after coronary artery bypass surgery. Coron Artery Dis 1996; 7: 475-8.
  67. Rostagno C, Taddei T, Paladini B et al. The onset of symptomatic atrial fibrillation and paroxysmal supraventricular tachycardia is characterized by different circadian rhythms. Am J Cardiol 1993; 71: 453-5.
  68. Yamashita T, Murakawa Y, Sezaki K et al. Circadian variation of paroxysmal atrial fibrillation. Circulation 1997; 96: 1537-41.
  69. Koshino Y, Satoh M, Katayose Y et al. Association of sleep - disordered breathing and ventricular arrhythmias in patients without heart failure. Am J Cardiol 2008; 101: 882-6.
  70. Stevenson I.H, Teichtahl H, Cunnington D et al. Prevalence of sleep disordered breathing in paroxysmal and persistent atrial fibrillation patients with normal left ventricular function. Eur Heart J 2008; 29: 1662-9.
  71. Lee S.A, Amis T.C, Byth K et al. Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 2008; 31: 1207-13.
  72. Brown D.L. Sleep disorders and stroke. Semin Neurol 2006; 26: 117-22.
  73. Yaggi H, Mohsenin V. Obstructive sleep apnoea and stroke. Lancet Neurol 2004; 3: 333-42.
  74. Htoo A.K, Greenberg H, Tongia S et al. Activation of nuclear factor kappa B in obstructive sleep apnea: a pathway leading to systemic inflammation. Sleep Breath 2006; 10: 43-50
  75. Yan-Fang S, Yu - ping W. Sleep - disordered breathing: impact on functional outcome of ischemic stroke patients. Sleep Med 2009; 10: 717-9.
  76. Good D.C, Henkle J.Q, Gelber D et al. Sleep - disordered breathing and poor functional outcome after stroke. Stroke 1996; 27: 252-9.
  77. Kaneko Y, Hajek V.E, Zivanovic V et al. Relationship of sleep apnea to functional capacity and length of hospitalization following stroke. Sleep 2003; 26: 293-7.
  78. Sahlin C, Sandberg O, Gustafson Y et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow - up. Arch Intern Med 2008; 168: 297-301.
  79. Sandberg O, Franklin K.A, Bucht G et al. Nasal continuous positive airway pressure in stroke patients with sleep apnoea: a randomized treatment study. Eur Respir J 2001; 18: 630-4.
  80. Hsu C.Y, Vennelle M, Li H.Y et al. Sleep - disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure. J Neurol Neurosurg Psychiatry 2006; 77: 1143-9.
  81. Martinez-Garcia M.A, Soler-Cataluna J.J, Ejarque-Martinez L et al. Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow - up study. Am J Respir Crit Care Med 2009; 180: 36-41.
  82. American Heart Association/American Stroke Association Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke 2014; 45: 210-36.

Copyright (c) 2022 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies