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[Cardiac dysfunction and the obstructive sleep apnoea syndrome].

V Bocquillon1, M Destors1, R Guzun1

  • 1Inserm 1042, laboratoire HP2, Université Grenoble-Alpes, 38000 Grenoble, France; Pôle thorax et vaisseaux, clinique de physiologie sommeil et exercice, CHU de Grenoble-Alpes, 38000 Grenoble, France.

Revue Des Maladies Respiratoires
|December 24, 2019
PubMed
Summary

Sleep apnoea syndrome (SAS) significantly worsens cardiac insufficiency and is linked to higher mortality. Combined treatment of SAS and cardiac conditions is crucial for better patient outcomes.

Keywords:
Arterial hypertensionCardiac insufficiencyContinuous positive pressure ventilationHypertension artérielleInsuffisance cardiaqueServo-assisted ventilation.Sleep apnoea syndromeSyndrome d’apnée du sommeilVentilation en pression positive continueVentilation servo-assistée

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pulmonology

Background:

  • Cardiac insufficiency impacts 2% of the population, with sleep apnoea syndrome (SAS) as a significant risk factor and aggravator.
  • SAS is highly prevalent in patients with chronic heart failure (70%), hypertension (65%), stroke (60%), and atrial fibrillation (50%), increasing cardiovascular mortality by 2-3 times.
  • Pathophysiological mechanisms include nocturnal hypoxia, CO2 fluctuations, intrathoracic pressure changes, and sleep arousals, leading to sympathetic hyperactivity, endothelial dysfunction, and inflammation.

Purpose of the Study:

  • To highlight the critical link between sleep apnoea syndrome and cardiac insufficiency.
  • To emphasize the need for integrated management strategies for patients with both conditions.

Main Methods:

  • This study reviews existing literature and clinical data on the co-occurrence and impact of SAS in patients with cardiac dysfunction.
  • Analysis of pathophysiological mechanisms linking SAS to cardiovascular complications.

Main Results:

  • Sleep apnoea syndrome is a prevalent comorbidity in patients with various cardiovascular conditions, significantly increasing morbidity and mortality.
  • The combination of intermittent hypoxia, sympathetic hyperactivity, and inflammation driven by SAS exacerbates myocardial dysfunction.

Conclusions:

  • Integrated management of sleep apnoea syndrome and cardiac conditions is essential for patients with myocardial dysfunction.
  • Further research is needed to establish clear care pathways and define the roles of cardiological and pulmonary interventions.