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Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

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Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
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Heart Failure II: Pathophysiology01:29

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

395
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Related Experiment Video

Updated: Feb 12, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Sleep Apnea in Heart Failure.

MuChun Tsai1, Rami Khayat2,3

  • 1Division of Pulmonary Critical Care and Sleep, The Ohio State University, 201 DHLRI 473 West 12th Avenue, Columbus, OH, 43210, USA.

Current Treatment Options in Cardiovascular Medicine
|March 24, 2018
PubMed
Summary

Positive airway pressure (PAP) therapy for sleep-disordered breathing (SDB) in heart failure (HF) patients shows no cardiovascular benefit. Recent trials indicate no reduction in cardiovascular events or mortality, with some risks noted for specific PAP devices.

Keywords:
Adaptive servo ventilationCentral sleep apneaContinuous positive airway pressureEjection fractionHeart failureObstructive sleep apneaSleep-disordered breathing

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Area of Science:

  • Cardiology
  • Pulmonology
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) is common in heart failure (HF) patients.
  • Positive airway pressure (PAP) devices have been a primary treatment for SDB in HF.
  • Emerging therapies are also being investigated.

Purpose of the Study:

  • To review current SDB treatments in HF patients.
  • To evaluate the role of PAP devices and emerging therapies.
  • To discuss recent trial findings on PAP devices in HF.

Main Methods:

  • Review of current literature and recent randomized controlled trials (RCTs).
  • Analysis of studies evaluating PAP therapy (CPAP, ASV) in HF patients with SDB.
  • Examination of clinical outcomes, including cardiovascular events and mortality.

Main Results:

  • RCTs found no benefit of PAP therapy in reducing fatal/non-fatal cardiovascular events in HF patients.
  • The SAVE trial showed no improvement in cardiovascular effects with CPAP for OSA in CV disease.
  • The SERVE-HF trial indicated potential increased mortality with ASV in HF patients with CSA.

Conclusions:

  • Current evidence does not support PAP therapy for improving cardiovascular outcomes or survival in HF patients with SDB.
  • While PAP may improve OSA symptoms, its impact on major adverse cardiovascular events remains unproven.
  • Further research is needed to clarify the role of SDB treatment in HF management.