https://doi.org/10.4081/monaldi.2023.2660
Sleep-disordered breathing and heart failure: a vicious cycle of cardiovascular risk
Submitted: June 11, 2023
Accepted: August 10, 2023
Published: September 1, 2023
Accepted: August 10, 2023
Abstract Views: 1106
PDF: 74
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Sleep-disordered breathing (SDB) represents an important cardiovascular risk factor that is still often underestimated and not always optimally treated. Such breathing disorders can induce several harmful effects on the heart, also favoring the development of arrhythmias, ischemic heart disease, and left ventricular remodeling. Obstructive sleep apnea syndrome (OSA) is more frequent in heart failure patients than in the general population, promoting the worsening of left ventricular dysfunction. Both sleep apnea and heart failure have common clinical manifestations but also similar neurohormonal characteristics, contributing to the development and progression of heart failure and resulting in increased mortality. The pathophysiological mechanisms underlying left ventricular dysfunction associated with SDB will be analyzed, and the potential therapeutic effects of gliflozins on OSA in heart failure patients will be discussed.
Redline S, Foody J. Sleep disturbances: time to join the top 10 potentially modifiable cardiovascular risk factors?. Circulation 2011;124:2049-51.
Lyons OD, Bradley TD. Heart failure and sleep apnea. Can J Cardiol 2015;31:898-908.
Javaheri S. Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report. Int J Cardiol 2006;106:21-8.
Vazir A, Hastings PC, Dayer M, et al. A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction. Eur J Heart Fail 2007;9:243-50.
Kasai T, Bradley TD. Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol 2011;57:119-27.
Marin JM, Carrizo SJ, Vicente E, et al. 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.
Arzt M, Floras JS, Logan AG, et al. Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian continuous positive airway pressure for patients with central sleep apnea and heart failure trial (CANPAP). Circulation 2007;115:3173-80.
Cowie MR, Woehrle H, Wegscheider K, et al. Adaptive servo-ventilation for central sleep apnea in systolic heart failure. N Engl J Med 2015;373:1095-105.
Jaffuel D, Nogue E, Berdague P, et al. Sacubitril-valsartan initiation in chronic heart failure patients impacts sleep apnea: the ENTRESTO-SAS study. ESC Heart Fail 2021;8:2513-26.
Nassif ME, Kosiborod M. Effects of sodium glucose cotransporter type 2 inhibitors on heart failure. Diabetes Obes Metab 2019;21:s19-23.
Sawada K, Karashima S, Kometani M, et al. Effect of sodium glucose cotransporter 2 inhibitors on obstructive sleep apnea in patients with type 2 diabetes. Endocr J 2018;65:461-7.
Yeghiazarians Y, Jneid H, Tietjens JR, et al. Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2021;144:e56-e67. Erratum in: Circulation 2022;145:e775.
Lombardi C, Pengo MF, Parati G. Obstructive sleep apnea syndrome and autonomic dysfunction. Auton Neurosci 2019;221:102563.
Cowie MR, Linz D, Redline S, et al. Sleep disordered breathing and cardiovascular disease: JACC state-of-the-art review. J Am Coll Cardiol 2021;78:608-24.
Verbrugge FH, Omote K, Reddy YNV, et al. Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J 2022;43:1941-51.
Tamisier R, Pépin JL, Woehrle H, et al. Effect of adaptive servo-ventilation for central sleep apnoea in systolic heart failure on muscle sympathetic nerve activity: a SERVE-HF randomised ancillary study. Eur Respir J 2023;61:2200384.
Bradley TD, Floras JS. Sleep apnea and heart failure: part II: central sleep apnea. Circulation 2003;107:1822-6.
Neeland IJ, Eliasson B, Kasai T, et al. The impact of empagliflozin on obstructive sleep apnea and cardiovascular and renal outcomes: an exploratory analysis of the EMPA-REG OUTCOME trial. Diabetes Care 2020;43:3007-15.
Tang Y, Sun Q, Bai XY, et al. Effect of dapagliflozin on obstructive sleep apnea in patients with type 2 diabetes: a preliminary study. Nutr Diabetes 2019;9:32.
Furukawa S, Miyake T, Senba H, et al. The effectiveness of dapagliflozin for sleep-disordered breathing among Japanese patients with obesity and type 2 diabetes mellitus. Endocr J 2018;65:953-61.
Wojeck BS, Inzucchi SE, Neeland IJ, et al. Ertugliflozin and incident obstructive sleep apnea: an analysis from the VERTIS CV trial. Sleep Breath 2023;27:669-72.
Obokata M, Reddy YNV, Pislaru SV, et al. Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction. Circulation 2017;136:6-19.
Zelniker TA, Braunwald E. Mechanisms of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC state-of-the-art review. J Am Coll Cardiol 2020;75:422-34. Erratum in: J Am Coll Cardiol 2020;76:1505.
Sano M, Goto S. Possible mechanism of hematocrit elevation by sodium glucose cotransporter 2 inhibitors and associated beneficial renal and cardiovascular effects. Circulation 2019;139:1985-7.
Ekanayake P, Mudaliar S. Increase in hematocrit with SGLT-2 inhibitors - hemoconcentration from diuresis or increased erythropoiesis after amelioration of hypoxia?. Diabetes Metab Syndr 2022;17:102702.
Monda VM, Gentile S, Porcellati F, et al. Heart failure with preserved ejection fraction and obstructive sleep apnea: a novel paradigm for additional cardiovascular benefit of SGLT2 inhibitors in subjects with or without type 2 diabetes. Adv Ther 2022;39:4837-46.
Ethics Approval
This study was approved by the Institutional Ethics Committee.How to Cite
Cacciapuoti, Fulvio, Antonio D’Onofrio, Luca Gaetano Tarquinio, Valentina Capone, Ciro Mauro, Raffaele Marfella, and Federico Cacciapuoti. 2023. “Sleep-Disordered Breathing and Heart Failure: A Vicious Cycle of Cardiovascular Risk”. Monaldi Archives for Chest Disease 94 (2). https://doi.org/10.4081/monaldi.2023.2660.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Gabriele Valli, Francesca De Marco, Maria Teresa Spina, Valentina Valeriano, Antonello Rosa, Valentina Minerva, Enrico Mirante, Maria Pia Ruggieri, Francesco Rocco Pugliese, A pilot study on the application of the current European guidelines for the management of acute coronary syndrome without elevation of ST segment (NSTEMI) in the Emergency Department setting in the Italian region Lazio , Monaldi Archives for Chest Disease: Vol. 82 No. 4 (2014): Cardiac series
- Alberto Genovesi Ebert, Furio Colivicchi, Marco Malvezzi Caracciolo, Carmine Riccio, Additive beneficial effects of beta blockers in the prevention of symptomatic heart failure , Monaldi Archives for Chest Disease: Vol. 72 No. 1 (2009): Cardiac series
- Donatella Del Sindaco, Giovanni Pulignano, Andrea Di Lenarda, Luigi Tarantini, Giovanni Cioffi, Stefano Tolone, Maria Denitza Tinti, Luca Monzo, Giulia Barbati, Giovanni Minardi, Role of a multidisciplinary program in improving outcomes in cognitively impaired heart failure older patients , Monaldi Archives for Chest Disease: Vol. 78 No. 1 (2012): Cardiac series
- Panagiotis Hountis, Maria Chounti, Chilaiditi’s sign or syndrome? Diagnostic question in two patients with concurrent cardiovascular diseases , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Massimiliano Polastri, Lara Pisani, Andrea Dell'Amore, Stefano Nava, Revolving door respiratory patients: A rehabilitative perspective , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Erick Chan, Francesco Giallauria, Carlo Vigorito, Neil A. Smart, Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis , Monaldi Archives for Chest Disease: Vol. 86 No. 1-2 (2016): Cardiac series
- Roberto Valle, Renzo Baccichetto, Sabrina Barro, Alessandro Calderan, Emanuele Carbonieri, Maura Chinellato, Mario Chiatto, Alessandra D’Eri, Francesco Corazza, Massimo D’Atri, Raffaela Drigo, Simeone Fabris, Giuseppe Fabris Gelli, Antonio Lo Giudice, Federica Noventa, Alessandro Pollon, Paolo Santin, Franco Zanardi, Loredano Milani, Heart failure in Eastern Veneto: prevalence, hospitalization rate, adherence to guidelines and social costs , Monaldi Archives for Chest Disease: Vol. 66 No. 1 (2006): Cardiac series
- Vittorio Palmieri, Antonio Palermo, Patients’ self-evaluation of symptoms, signs and compliance to therapy for heart failure surveillance: A pilot study on identification of worsening heart failure , Monaldi Archives for Chest Disease: Vol. 88 No. 2 (2018)
- Paola Gremigni, Cynical hostility and the metabolic syndrome: A case-control study , Monaldi Archives for Chest Disease: Vol. 66 No. 3 (2006): Cardiac series
- Giovanni Pulignano, Maria Denitza Tinti, Donatella Del Sindaco, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni, Barriers to cardiac rehabilitation access of older heart failure patients and strategies for better implementation , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
You may also start an advanced similarity search for this article.
