Cardiovascular mechanisms and consequences of obstructive sleep apnoea

Acta Clinica Belgica

Volumn 68, Issue 3, 2013, Pages 169-178

  Vrints, H ^a,b   Shivalkar, B ^a,b   Hilde, Heuten ^a,b   Vanderveken, O M ^a,b   Hamans, E ^a,b   Van De Heyning, P ^a,b   De Backer, W ^a,b   Verbraecken, J ^a,b  

^a ANTWERP UNIVERSITY HOSPITAL   (Belgium)

^b UNIVERSITY OF ANTWERP   (Belgium)

Author keywords

Cardiovascular consequences; OSA; Review

Indexed keywords

ARTICLE; CARDIOVASCULAR DISEASE; CEREBROVASCULAR ACCIDENT; CORONARY ARTERY DISEASE; ENDOTHELIAL DYSFUNCTION; HEART DEATH; HEART INFARCTION; HYPERTENSION; INSULIN RESISTANCE; OXIDATIVE STRESS; POSITIVE END EXPIRATORY PRESSURE; RISK FACTOR; SLEEP DISORDERED BREATHING; SYMPATHETIC TONE; THORAX PRESSURE; THROMBOSIS; HUMAN; PATHOPHYSIOLOGY; REVIEW; CARDIOVASCULAR DISEASES; COMPLICATION; SLEEP APNEA, OBSTRUCTIVE;

CARDIOVASCULAR DISEASES; CONTINUOUS POSITIVE AIRWAY PRESSURE; HUMANS; RISK FACTORS; SLEEP APNEA, OBSTRUCTIVE;

EID: 84891650736     PISSN: 00015512     EISSN: None     Source Type: Journal    
DOI: 10.2143/ACB.2981     Document Type: Article

References (175)

1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-1235
2. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: A population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-1239
3. Shahar E, Whitney CRS. 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
4. Libby P. Changing concepts of atherogenesis. J Intern Med 2000; 247: 349-358
5. Drager L, Bortolotto L, Lorenzi M, Figueiredo A, Krieger E, Lorenzi-Filho G. Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2005; 172: 613-618
6. Punjabi NM, Polotsky VY. Disorders of glucose metabolism in sleep apnea. J Appl Physiol 2005; 99: 1998-2007
7. Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE. Sleep-disordered breathing, glucose intolerance, and insulin resistance: The Sleep Heart Health Study. Am J Epidemiol 2004; 160: 521-530
8. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis. Circulation 2007; 115: 459-467
9. Marin JM, Carrizo SJ, Vicente E, Agusti AG. 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: 1046-1053
10. Morgan BJ, Crabtree DC, Puleo DS, Badr MS, Toiber F, Skatrud JB. Neurocirculatory consequences of abrupt change in sleep state in humans. J Appl Physiol 1996; 80: 1627-1636
11. Horner RL, Brooks D, Kozar LF, Tse S, Phillipson EA. Immediate effects of arousal from sleep on cardiac autonomic outflow in the absence of breathing in dogs. J Appl Physiol 1995; 79: 151-162
12. Narkiewicz K, Montano N, Cogliati C, Van De Borne P, Dyken M, Somers V. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 15: 1071-1077
13. Pankow W, Nabe B, Lies A, et al. Influence of sleep apnea on 24-hour blood pressure. Chest 1997; 112: 1253-1258
14. Narkiewicz K, Van De Borne PJ, Cooley RL, Dyken ME, Somers VK. Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation 1998; 98: 772-776
15. Narkiewicz K, Van De Borne PJ, Montano N, Dyken ME, Phillips BG, Somers VK. Contribution of tonic chemoreflex activation to sympathetic activity and blood pressure in patients with obstructive sleep apnea. Circulation 1998; 97: 943-945
16. Maser RE, Lenhard MJ, Rizzo AA, Vasile AA. Continuous positive airway pressure therapy improves cardiovascular autonomic function for persons with sleep-disordered breathing. Chest 2008; 133: 86-91
17. Mills PJ, Kennedy BP, Loredo JS, Dimsdale JE, Ziegler MG. Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea. J Appl Physiol 2006; 100: 343-348
18. Bonsignore MR, Parati G, Insalaco G, et al. Continuous positive airway pressure treatment improves baroreflex control of heart rate during sleep in severe obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2002; 166: 279-286
19. Noda A, Nakata S, Koike Y, et al. Continuous positive airway pressure improves daytime baroreflex sensitivity and nitric oxide production in patients with moderate to severe obstructive sleep apnea syndrome. Hypertens Res 2007; 30: 669-676
20. Frattola A, Parati G, Cuspidi C, Albini F, Mancia G. Prognostic value of 24-hour blood pressure variability. J Hypertens 1993; 11: 1133-1137
21. Singh J, Larson M, Tsuji H, Evans J, O?Donnell C, Levy D. Reduced heart rate variability and new-onset hypertension: Insights into pathogenesis of hypertension: The Framingham Heart Study. Hypertension 1998; 32: 293-297
22. Ponikowski P, Anker SD, Chua TP, et al. Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 1997; 79: 1645-1650
23. Buda AJ, Pinsky MR, Ingels NB, et al. Effect of intrathoracic pressure on left ventricular performance. N Engl J Med 1979; 301: 453-459
24. Floras JS, Bradley TD. Treating obstructive sleep apnea: Is there more to the story than 2 millimeters of mercury Hypertension 2007; 50: 289-291
25. Somers VK, Dyken ME, Skinner JL. Autonomic and hemodynamic responses and interactions during the Mueller maneuver in humans. J Auton Nerv Syst 1993; 44: 253-259
26. Virolainen J, Ventila M, Turto H, Kupari M. Effect of negative intrathoracic pressure on left ventricular pressure dynamics and relaxation. J Appl Physiol 1995; 79: 455-460
27. White SG, Fletcher EC, Miller CC, III. Acute systemic blood pressure elevation in obstructive and nonobstructive breath hold in primates. J Appl Physiol 1995; 79: 324-330
28. Bradley TD. Right and left ventricular functional impairment and sleep apnea. Clin Chest Med 1992; 13: 459-479
29. Stoohs R, Guilleminault C. Cardiovascular changes associated with obstructive sleep apnea syndrome. J Appl Physiol 1992; 72: 583-589
30. Kusuoka H, Weisfeldt M, Zweier J, Jacobus W, Marban E. Mechanism of early contractile failure during hypoxia in intact ferret heart: Evidence for modulation of maximal CA2+-activated force by inorganic phosphate. Circ Res 1986; 59: 270-282
31. Cargill RI, Kiely DG, Lipworth BJ. Adverse effects of hypoxaemia on diastolic filling in humans. Clin Sci Lond 1995; 89: 165-169
32. Shivalkar B, Van De Heyning C, Kerremans M, et al. Obstructive sleep apnea syndrome: More insights on structural and functional cardiac alterations, and the effects of treatment with continuous positive airway pressure. J Am Coll Cardiol 2006; 47: 1433-1439
33. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules axpression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med 2002; 1: 934-939
34. Yokoe T, Minoguchi K, Matsuo H, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 2003; 107: 1129-1134
35. Ryan S, Taylor CT, Mc Nicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 2005; 112: 2660-2667
36. Ryan S, Taylor CT, Mc Nicholas WT. Predictors of elevated nuclear factor-kappaB-dependent genes in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2006; 174: 824-830
37. Schulz R, Mahmoudi S, Hattar K, et al. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 2000; 162: 566-570
38. 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: 612-617
39. Ohga E, Tomita T, Wada H, Yamamoto H, Nagase T, Ouchi Y. Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol 2003; 94: 179-184
40. Shamsuzzaman AS, Winnicki M, Lanfranchi P, et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462-2464
41. Larkin EK, Rosen CL, Kirchner HL, et al. Variation of C-reactive protein levels in adolescents: Association with sleep-disordered breathing and sleep duration. Circulation 2005; 111: 1978-1984
42. Punjabi NM, Beamer BA. C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 2007; 30: 29-34
43. Svatikova A, Wolk R, Shamsuzzaman AS, Kara T, Olson EJ, Somers VK. Serum amyloid a in obstructive sleep apnea. Circulation 2003; 108: 1451-1454
44. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342: 836-843
45. Ridker PM, Rifai N, Pfeffer M, Sacks F, Lepage S, Braunwald E. Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction. Circulation 2000; 101: 2149-2153
46. Drummond M, Winck J, Guimaraes J, Santos AC, Almeida J, Marques J. Long term effect of autoadjusting positive airway pressure on C-reactive protein and interleukin-6 in men with obstructive sleep apnoea syndrome. Arch Bronconeumol 2009; 45: 577-584
47. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med 2002; 165: 934-939
48. Bedwell S, Dean RT, Jessup W. The action of defined oxygen-centred free radicals on human low-density lipoprotein. Biochem J 1989; 262: 707-712
49. Faller DV. Endothelial cell responses to hypoxic stress. Clin Exp Pharmacol Physiol 1999; 26: 74-84
50. Carlson JT, Rangemark C, Hedner JA. Attenuated endothelium-dependent vascular relaxation in patients with sleep apnoea. J Hypertens 1996; 14: 577-584
51. Chin K, Nakamura T, Shimizu K, et al. Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome. Am J Med 2000; 109: 562-567
52. Lavie L, Kraiczi H, Hefetz A, et al. Plasma vascular endothelial growth factor in sleep apnea syndrome: Effects of nasal continuous positive air pressure treatment. Am J Respir Crit Care Med 2002; 165: 1624-1628
53. Schulz R, Hummel C, Heinemann S, Seeger W, Grimminger F. Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe nighttime hypoxia. Am J Respir Crit Care Med 2002; 165: 67-70
54. Ishida K, Kato M, Kato Y, et al. Appropriate use of nasal continuous positive airway pressure decreases elevated C-reactive protein in patients with obstructive sleep apnea. Chest 2009; 136: 125-129
55. Hoffmann MS, Singh P, Wolk R, Romero-Corral A, Raghavakaimal S, Somers VK. Microarray studies of genomic oxidative stress and cell cycle responses in obstructive sleep apnea. Antioxid Redox Signal 2007; 9: 661-669
56. Christou K, Kostikas K, Pastaka C, Tanou K, Antoniadou I, Gourgoulianis KI. Nasal continuous positive airway pressure treatment reduces systemic oxidative stress in patients with severe obstructive sleep apnea syndrome. Sleep Med 2009; 10: 87-94
57. Svatikova A, Wolk R, Wang HH, et al. Circulating free nitrotyrosine in obstructive sleep apnea. Am J Physiol Regul Integr Comp Physiol 2004; 287: R284-R287
58. Takahashi K, Chin K, Nakamura H, et al. Plasma thioredoxin, a novel oxidative stress marker, in patients with obstructive sleep apnea before and after nasal continuous positive airway pressure. Antioxid Redox Signal 2008; 10: 715-726
59. Kraiczi H, Caidahl K, Samuelsson A, Peker Y, Hedner J. Impairment of vascular endothelial function and left ventricular filling: Association with the severity of apnea-induced hypoxemia during sleep. Chest 2001; 119: 1085-1091
60. Bayram NA, Ciftci B, Keles T, et al. Endothelial function in normotensive men with obstructive sleep apnea before and 6 months after CPAP treatment. Sleep 2009; 32: 1257-1263
61. Nieto FJ, Herrington DM, Redline S, Benjamin EJ, Robbins JA. Sleep apnea and markers of vascular endothelial function in a large community sample of older adults. Am J Respir Crit Care Med 2004; 169: 354-360
62. Jelic S, Padeletti M, Kawut SM, et al. Inflammation, oxidative stress, and repair capacity of the vascular endothelium in obstructive sleep apnea. Circulation 2008; 117: 2270-2278
63. Vita JA, Keaney JF Jr. Endothelial function: A barometer for cardiovascular risk Circulation 2002; 106: 640-642
64. Kato M, Roberts-Thomson P, Philips B, Haynes W, Winniki M, Accurso V, Somers V. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation 2000; 21: 2607-2610
65. Schulz R, Schmidt D, Blum A, et al. Decreased plasma levels of nitric oxide derivatives in obstructive sleep apnoea: Response to CPAP therapy. Thorax 2000; 55: 1046-1051
66. Phillips BG, Narkiewicz K, Pesek CA, Haynes WG, Dyken ME, Somers VK. Effects of obstructive sleep apnea on endothelin-1 and blood pressure. J Hypertens 1999; 17: 61-66
67. Kourembanas S, Marsden PA, McQuillan LP, Faller DV. Hypoxia induces endothelin gene expression and secretion in cultured human endothelium. J Clin Invest 1991; 88: 1054-1057
68. Gjorup PH, Sadauskiene L, Wessels J, Nyvad O, Strunge B, Pedersen EB. Abnormally increased endothelin-1 in plasma during the night in obstructive sleep apnea: Relation to blood pressure and severity of disease. Am J Hypertens 2007; 20: 44-52
69. Kraiczi H, Hedner J, Peker Y, Carlson J. Increased vasoconstrictor sensitivity in obstructive sleep apnea. J Appl Physiol 2000; 89: 493-498
70. El Solh AA, Akinnusi ME, Baddoura FH, Mankowski CR. Endothelial cell apoptosis in obstructive sleep apnea: A link to endothelial dysfunction. Am J Respir Crit Care Med 2007; 175: 1186-1191
71. Ip MS, Tse HF, Lam B, Tsang KW, Lam WK. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004; 169: 348-353
72. Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165: 670-676
73. Schahin SP, Nechanitzky T, Dittel C, et al. Long-term improvement of insulin sensitivity during CPAP therapy in the obstructive sleep apnoea syndrome. Med Sci Monit 2008; 14: CR117-CR121
74. Phillips B, Kato M, Narkiewicz K, Choe I, Somers V. Increases in leptin levels, sympathetic drive, and waight gain in obstructive sleep apnea. Am J Physiol Heart Cric Physiol 2000; 279: 234-237
75. Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 2002; 165: 677-682
76. von KR, Loredo JS, Ancoli-Israel S, Mills PJ, Natarajan L, Dimsdale JE. Association between polysomnographic measures of disrupted sleep and prothrombotic factors. Chest 2007; 131: 733-739
77. Steiner S, Jax T, Evers S, Hennersdorf M, Schwalen A, Strauer BE. Altered blood rheology in obstructive sleep apnea as a mediator of cardiovascular risk. Cardiology 2005; 104: 92-96
78. Hoffstein V, Herridge M, Mateika S, Redline S, Strohl KP. Hematocrit levels in sleep apnea. Chest 1994; 106: 787-791
79. Robinson GV, Pepperell JC, Segal HC, Davies RJ, Stradling JR. Circulating cardiovascular risk factors in obstructive sleep apnoea: Data from randomised controlled trials. Thorax 2004; 59: 777-782
80. Bokinsky G, Miller M, Ault K, Husband P, Mitchell J. Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure. A preliminary investigation. Chest 1995; 108: 625-630
81. Hui DS, Ko FW, Fok JP, et al. The effects of nasal continuous positive airway pressure on platelet activation in obstructive sleep apnea syndrome. Chest 2004; 125: 1768-1775
82. Peker Y, Hedner J, Norum J, Kraiczi H, Carlson J. 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: 159-165
83. Silverberg DS, Oksenberg A. Are sleep-related breathing disorders important contributing factors to the production of essential hypertension Curr Hypertens Rep 2001; 3: 209-215
84. Hedner J, Bengtsson-Bostrom K, Peker Y, Grote L, Rastam L, Lindblad U. Hypertension prevalence in obstructive sleep apnoea and sex: A population-based case-control study. Eur Respir J 2006; 27: 564-570
85. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000; 342: 1378-1384
86. Young T, Peppard P, Palta M, et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 1997; 157: 1746-1752
87. Mc Nicholas WT, Bonsigore MR. Sleep apnoea as an independent risk factor for cardiovascular disease: Current evidence, basic mechanisms and research priorities. Eur Respir J 2007; 29: 156-178
88. Doherty LS, Kiely JL, Swan V, Mc Nicholas WT. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005; 127: 2076-2084
89. Campos-Rodriguez F, Pena-Grinan N, Reyes-Nunez N, et al. Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest 2005; 128: 624-633
90. Suzuki M, Guilleminault C, Otsuka K, Shiomi T. Blood pressure "dipping" and "non-dipping" in obstructive sleep apnea syndrome patients. Sleep 1996; 19: 382-387
91. Davies CW, Crosby JH, Mullins RL, Barbour C, Davies RJ, Stradling JR. Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnoea and normal matched control subjects. Thorax 2000; 55: 736-740
92. Ben-Dov IZ, Kark JD, Ben-Ishay D, Mekler J, Ben-Arie L, Bursztyn M. Predictors of all-cause mortality in clinical ambulatory monitoring: Unique aspects of blood pressure during sleep. Hypertension 2007; 49: 1235-1241
93. Xie A, Skatrud JB, Crabtree DC, Puleo DS, Goodman BM, Morgan BJ. Neurocirculatory consequences of intermittent asphyxia in humans. J Appl Physiol 2000; 89: 1333-1339
94. Khayat RN, Xie A, Patel AK, Kaminski A, Skatrud JB. Cardiorespiratory effects of added dead space in patients with heart failure and central sleep apnea. Chest 2003; 123: 1551-1560
95. Katragadda S, Xie A, Puleo D, Skatrud JB, Morgan BJ. Neural mechanism of the pressor response to obstructive and nonobstructive apnea. J Appl Physiol 1997; 83: 2048-2054
96. Arabi Y, Morgan BJ, Goodman B, Puleo DS, Xie A, Skatrud JB. Daytime blood pressure elevation after nocturnal hypoxia. J Appl Physiol 1999; 87: 689-698
97. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-1836
98. Bixler EO, Vgontzas AN, Lin HM, et al. Association of hypertension and sleep-disordered breathing. Arch Intern Med 2000; 160: 2289-2295
99. Krieger J, Sforza E, Boudewijns A, Zamagni M, Petiau C. Respiratory effort during obstructive sleep apnea: Role of age and sleep state. Chest 1997; 112: 875-884
100. Dimsdale JE, Loredo JS, Profant J. Effect of continuous positive airway pressure on blood pressure: A placebo trial. Hypertension 2000; 35: 144-147
101. Faccenda JF, Mackay TW, Boon NA, Douglas NJ. Randomized placebo-controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea-hypopnea syndrome. Am J Respir Crit Care Med 2001; 163: 344-348
102. Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: A randomised parallel trial. Lancet 2002; 359: 204-210
103. Becker HF, Jerrentrup A, Ploch T, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003; 107: 68-73
104. Norman D, Loredo JS, Nelesen RA, et al. Effects of continuous positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood pressure. Hypertension 2006; 47: 840-845
105. Campos-Rodriguez F, Grilo-Reina A, Perez-Ronchel J, et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: A placebo-controlled trial. Chest 2006; 129: 1459-1467
106. Robinson G, Smith D, Langford B, Davies R, Stradling J. Continuoous positive airway pressure does not reduce blood pressure in nonsleepy hypertensive OSA patients. Eur Respir J 2006; 27: 1229-1235
107. Barbe F, Mayoralas LR, Duran J, et al. Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial. Ann Intern Med 2001; 134: 1015-1023
108. Vanderveken OM, Boudewyns A, Ni Q, et al. Cardiovascular implications in the treatment of obstructive sleep apnea. J Cardiovasc Transl Res 2011; 4: 53-60
109. Andrew SL Chan, Peter A Cistulli. Oral Appliance Treatment of Obstructive Sleep Apnea: An Update. Curr Opin Pulm Med 2009; 16: 591-596
110. Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet 2009; 373: 82-93
111. Randerath WJ, Heise M, Hinz R, Ruehle KH. An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest 2002; 122: 569-575
112. Chan J, Sanderson J, Chan W, et al. Prevalence of sleep-disordered breathing in diastolic heart failure. Chest 1997; 111: 1488-1493
113. Fung JW, Li TS, Choy DK, et al. Severe obstructive sleep apnea is associated with left ventricular diastolic dysfunction. Chest 2002; 121: 422-429
114. Arias MA, Garcia-Rio F, Alonso-Fernandez A, Mediano O, Martinez I, Villamor J. Obstructive sleep apnea syndrome affects left ventricular diastolic function: Effects of nasal continuous positive airway pressure in men. Circulation 2005; 112: 375-383
115. Lattimore JD, Celermajer DS, Wilcox I. Obstructive sleep apnea and cardiovascular disease. J Am Coll Cardiol 2003; 41: 1429-1437
116. Wolk R, Kara T, Somers VK. Sleep-disordered breathing and cardiovascular disease. Circulation 2003; 108: 9-12
117. Laaban JP, Pascal-Sebaoun S, Bloch E, Orvoen-Frija E, Oppert JM, Huchon G. Left ventricular systolic dysfunction in patients with obstructive sleep apnea syndrome. Chest 2002; 122: 1133-1138
118. Chen L, Einbinder E, Zhang Q, Hasday J, Balke CW, Scharf SM. Oxidative stress and left ventricular function with chronic intermittent hypoxia in rats. Am J Respir Crit Care Med 2005; 172: 915-920
119. Ferrier K, Campbell A, Yee B, et al. Sleep-disordered breathing occurs frequently in stable outpatients with congestive heart failure. Chest 2005; 128: 2116-2122
120. Javaheri S. Sleep disorders in systolic heart failure: A prospective study of 100 male patients. The final report. Int J Cardiol 2006; 106: 21-28
121. Kaneko Y, Floras JS, Usui K, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 2003; 348: 1233-1241
122. Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT. Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med 2004; 169: 361-366
123. Malone S, Liu PP, Holloway R, Rutherford R, Xie A, Bradley TD. Obstructive sleep apnoea in patients with dilated cardiomyopathy: Effects of continuous positive airway pressure. Lancet 1991; 338: 1480-1484
124. Verdecchia P, Schillaci G, Guerrieri M, et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation 1990; 81: 528-536
125. Portaluppi F, Provini F, Cortelli P, et al. Undiagnosed sleep-disordered breathing among male nondippers with essential hypertension. J Hypertens 1997; 15: 1227-1233
126. Peker Y, Kraiczi H, Hedner J, Loth S, Johansson A, Bende M. An independent association between obstructive sleep apnoea and coronary artery disease. Eur Respir J 1999; 14: 179-184
127. Sorajja D, Gami AS, Somers VK, Behrenbeck TR, Garcia-Touchard A, Lopez-Jimenez F. Independent association between obstructive sleep apnea and subclinical coronary artery disease. Chest 2008; 133: 927-933
128. Schafer H, Koehler U, Ewig S, Hasper E, Tasci S, Luderitz B. Obstructive sleep apnea as a risk marker in coronary artery disease. Cardiology 1999; 92: 79-84
129. 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: 596-602
130. Hayashi M, Fujimoto K, Urushibata K, Uchikawa S, Imamura H, Kubo K. Nocturnal oxygen desaturation correlates with the severity of coronary atherosclerosis in coronary artery disease. Chest 2003; 124: 936-941
131. King CR, Knutson KL, Rathouz PJ, Sidney S, Liu K, Lauderdale DS. Short sleep duration and incident coronary artery calcification. JAMA 2008; 300: 2859-2866
132. Hagenah GC, Gueven E, Andreas S. Influence of obstructive sleep apnoea in coronary artery disease: A 10-year follow-up. Respir Med 2006; 100: 180-182
133. Somers VK, White DP, 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. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research National Institutes of Health.. Circulation 2008; 118: 1080-1111
134. Franklin KA, Nilsson JB, Sahlin C, Naslund U. Sleep apnoea and nocturnal angina. Lancet 1995; 345: 1085-1087
135. Peled N, Abinader EG, Pillar G, Sharif D, Lavie P. Nocturnal ischemic events in patients with obstructive sleep apnea syndrome and ischemic heart disease: Effects of continuous positive air pressure treatment. J Am Coll Cardiol 1999; 34: 1744-1749
136. Gami AS, Svatikova A, Wolk R, et al. Cardiac troponin T in obstructive sleep apnea. Chest 2004; 125: 2097-2100
137. Narkiewicz K, Montano N, Cogliati C, Van De Borne PJ, Dyken ME, Somers VK. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 98: 1071-1077
138. Kuniyoshi FH, Garcia-Touchard A, Gami AS, et al. Day-night variation of acute myocardial infarction in obstructive sleep apnea. J Am Coll Cardiol 2008; 52: 343-346
139. 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: 728-734
140. Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban JP. Pulmonary arterial hypertension in patients with sleep apnoea syndrome. Thorax 2000; 55: 934-939
141. Sajkov D, Cowie RJ, Thornton AT, Espinoza HA, McEvoy RD. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1994; 149: 416-422
142. Sanner BM, Doberauer C, Konermann M, Sturm A, Zidek W. Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med 1997; 157: 2483-2487
143. Sajkov D, Cowie RJ, Thornton AT, Espinoza HA, McEvoy RD. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1994; 149: 4 16-22
144. Chaouat A, Weitzenblum E, Krieger J, Oswald M, Kessler R. Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Results in 220 consecutive patients. Chest 1996; 109: 380-386
145. Sajkov D, Wang T, Saunders NA, Bune AJ, Mcevoy RD. Continuous positive airway pressure treatment improves pulmonary hemodynamics in patients with obstructive sleep apnea. Am J Respir Crit Care Med 2002; 165: 152-158
146. Sajkov D, Wang T, Saunders NA, Bune AJ, Neill AM, Douglas MR. Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med 1999; 159: 1518-1526
147. Simonneau G, Galie N, Rubin LJ, et al. Clinical classification of pulmonary hypertension. J Am Coll Cardiol 2004; 43: 5S-12S
148. Good D, Henkle J, Gelber D, Welsh J, Verhulst S. Sleep-disordered breathing and poor functional outcome after stroke. Stroke 1996; 27: 252-259
149. Bassetti C, Milanova M, Grugger M. Sleep-disordered breathing and acute ischemic stroke: Diagnosis, risk factors, treatment,evolution, and long-term clinical outcome. Stroke 2006; 37: 967-972
150. Bassetti C, Aldrich MS, Chervin RD, Quint D. Sleep apnea in patients with transient ischemic attack and stroke: A prospective study of 59 patients. Neurology 1996; 47: 1167-1173
151. Wessendorf TE, Teschler H, Wang YM, Konietzko N, Thilmann AF. Sleep-disordered breathing among patients with first-ever stroke. J Neurol 2000; 247: 41-47
152. Baguet JP, Hammer L, Levy P, et al. The severity of oxygen desaturation is predictive of carotid wall thickening and plaque occurrence. Chest 2005; 128: 3407-3412
153. Suzuki T, Nakano H, Maekawa J, et al. Obstructive sleep apnea and carotid-artery intima-media thickness. Sleep 2004; 27: 129-133
154. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-2041
155. Parra O, Arboix A, Montserrat JM, Quinto L, Bechich S, Garcia-Eroles L. Sleep-related breathing disorders: Impact on mortality of cerebrovascular disease. Eur Respir J 2004; 24: 267-272
156. Arzt M, Young T, Finn L, Skatrud JB, Bradley TD. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med 2005; 172: 1447-1451
157. Wang H, Parker JD, Newton GE, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 2007; 49: 1625-1631
158. Wolk R, Somers VK. Sleep and the metabolic syndrome. Exp Physiol 2007; 92: 67-78
159. Palombini L, Guilleminault C. Stroke and treatment with nasal CPAP. Eur J Neurol 2006; 13: 198-200
160. Liston R, Deegan P, McCreery C, Mc Nicholas W. Role of respiratory sleep disorders in the pathogenesis of nocturnal angina and arrhythmias. Postgrad Med J 1994; 70: 275-280
161. Koehler U, Schafer H. Is obstructive sleep apnea OSA. a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease CHD. Sleep 1996; 19: 283-286
162. Shepard JW Jr. Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea. Clin Chest Med 1992; 13: 437-458
163. Mehra R, Benjamin EJ, 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: 910-916
164. Shepard JW Jr, Garrison MW, Grither DA, Dolan GF. Relationship of ventricular ectopy to oxyhemoglobin desaturation in patients with obstructive sleep apnea. Chest 1985; 88: 335-340
165. Ryan CM, Usui K, Floras JS, Bradley TD. Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnoea. Thorax 2005; 60: 781-785
166. Becker HF, Koehler U, Stammnitz A, Peter JH. Heart block in patients with sleep apnoea. Thorax 1998; 53: S29-S32
167. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983; 52: 490-494
168. Simantirakis EN, Schiza SI, Marketou ME, et al. Severe bradyarrhythmias in patients with sleep apnoea: The effect of continuous positive airway pressure treatment: A long-term evaluation using an insertable loop recorder. Eur Heart J 2004; 25: 1070-1076
169. Koehler U, Becker HF, Grimm W, Heitmann J, Peter JH, Schafer H. Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea. Am Heart J 2000; 139: 142-148
170. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-1836
171. Peker Y, Kraiczi H, Hedner J, Loth S, Johansson A, Bende M. An independent association between obstructive sleep apnoea and coronary artery disease. Eur Respir J 1999; 14: 179-184
172. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-2041
173. Stoohs RA, Gingold J, Cohrs S, Harter R, Finlayson E, Guilleminault C. Sleep-disordered breathing and systemic hypertension in the older male. J Am Geriatr Soc 1996; 44: 1295-1300
174. Zamarron C, Gude F, Otero Y, Alvarez JM, Golpe A, Rodriguez JR. Prevalence of sleep disordered breathing and sleep apnea in 50-to 70-year-old individuals. A survey. Respiration 1999; 66: 317-322
175. Haas DC, Foster GL, Nieto FJ, et al. Age-dependent associations between sleep-disordered breathing and hypertension: Importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 2005; 111: 614-621.