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Obstructive Sleep Apnea Impacts Cardiac Function in Dilated Cardiomyopathy Patients Through Circulating Exosomes

Hui Gong1, Xing Lyu2, Lini Dong1

  • 1Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, China.

Frontiers in Cardiovascular Medicine
|March 24, 2022
PubMed

Insights

Severe obstructive sleep apnea (OSA) worsens heart function in dilated cardiomyopathy (DCM) patients. OSA-derived exosomes impair autophagy via the Akt/mTOR pathway, contributing to cardiac remodeling and heart failure.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Molecular Biology

Background:

  • Obstructive sleep apnea (OSA) is prevalent and linked to heart failure.
  • Dilated cardiomyopathy (DCM) patients often have co-existing OSA, impacting cardiac function.
  • The role of exosomes and autophagy in OSA-related cardiac dysfunction requires further investigation.

Purpose of the Study:

  • To examine the effect of OSA on heart function in DCM patients.
  • To elucidate the mechanism involving exosomes and autophagy in OSA-induced cardiac changes.
  • To explore potential therapeutic targets for heart failure in OSA patients.

Main Methods:

  • Retrospective analysis of 126 DCM patients with sleep evaluations.
  • In vitro study using cardiomyocytes treated with exosomes from OSA patients and controls.
  • Evaluation of fibrotic/hypertrophic markers and Akt/mTOR-mediated autophagy.

Main Results:

  • Severe OSA in DCM patients correlated with larger right ventricular/atrial diameters and elevated NT-proBNP.
  • OSA-derived exosomes increased cardiac fibrosis markers (Col1A1, ANP, BNP) and reduced autophagy markers (LC3B II/I, beclin1).
  • Rapamycin treatment reversed OSA exosome-induced cardiac changes and restored autophagy.

Conclusions:

  • OSA severity is associated with cardiac injury and remodeling in DCM.
  • Exosomes regulating autophagy via the Akt/mTOR pathway mediate OSA's cardiac impact.
  • This research offers insights into treating heart failure in patients with OSA.
Abstract

Keywords:
Dilated Cardiomyopathyautophagyexosomesheart failureobstructive sleep apnea

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