Cardiovascular Abnormalities in Sleep-Disordered Breathing

Brooke G. Judd; Stephen Liu; Michael J. Sateia

doi:10.1055/s-2003-41092

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2003; 24(3): 315-322
DOI: 10.1055/s-2003-41092

Cardiovascular Abnormalities in Sleep-Disordered Breathing

Brooke G. Judd^1,2 , Stephen Liu³ , Michael J. Sateia¹

¹Sleep Disorders Center, Dartmouth Medical School, Hanover, New Hampshire
²Department of Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
³Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

Abstract

ABSTRACT

The role of sleep-disordered breathing (SDB) in the development of persistent daytime pulmonary hypertension (PH) and cor pulmonale is controversial and has not been extensively studied. In this review we discuss the physiological changes that occur during SDB in the cardiovascular system, as well as review the most recent literature examining the relationship between SDB and PH/cor pulmonale. The literature suggests that much of the PH and right heart dysfunction seen in SDB is related to concurrent obesity and underlying lung disease, although it does appear that isolated SDB (in the form of obstructive sleep apnea) may be responsible for a small but significant degree of PH. The clinical consequences of this, however, remain unclear.

KEYWORDS

Sleep-disordered breathing - obstructive sleep apnea - pulmonary hypertension - cor pulmonale

Volltext

Referenzen

REFERENCES

1 Leung R ST, Bradley T D. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med . 2001; 164 2147-2165
2 Phillips B G, Somers V K. Sleep-disordered breathing and risk factors for cardiovascular disease. Curr Opin Pulm Med . 2002; 8 516-520
3 Weiss J W, Remsburg S, Garpestad E, Ringler J, Sparrow D, Parker J A. Hemodynamic consequences of obstructive sleep apnea. Sleep . 1996; 19 388-397
4 Malik A, Vogel S, Minshall R, Tiruppathi C. Pulmonary circulation and regulation of fluid balance. In: Murray J, Nadel J, eds. Textbook of Respiratory Medicine Philadelphia: WB Saunders 2000: 129-131
5 Nattie E E, Bartlett Jr D, Johnson K. Pulmonary hypertension and right ventricular hypertrophy caused by intermittent hypoxia and hypercapnia in the rat. Am Rev Respir Dis . 1978; 118 653-658
6 Simon P M, Landry S, Leiter J C. Respiratory control during sleep. In: Lee-Chiong TL Jr, Sateia M, Carskadon M, eds. Sleep Medicine Philadelphia: Hanley and Belfus 2002: 41-51
7 Chokroverty S. Physiologic changes in sleep. In: Chokroverty S, ed. Sleep Disorders Medicine Woburn MA: Butterworth-Heinemann 1999: 95-126
8 Peppard P E, Young T, Palta M, Skatrund J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med . 2000; 342 1378-1384
9 Shahar E, Whitney C W, Redline S. et al . Sleep-disordered breathing and cardiovascular disease. Am J Respir Crit Care Med . 2001; 163 19-25
10 Hanly P, Sasson Z, Zuberi N, Alderson M. Ventricular function in snorers and patients with obstructive sleep apnea. Chest . 1992; 102 100-105
11 Murray J. Disorders of the pulmonary circulation: general principles and diagnostic approach. In: Murray J, Nadel J, eds. Textbook of Respiratory Medicine Philadelphia: WB Saunders 2000 : 11485-1502
12 Phillipson E A. Sleep apnea. In: Braunwald E, Fauci A, Kasper DL, Hauser SL, Longo DL, Jameson JL, eds. Harrison's Principles of Internal Medicine New York: McGraw-Hill 2001: 1520-1523
13 Kessler R, Chauoat A, Weitzenblum E. et al . Pulmonary hypertension in the obstructive sleep apnoea syndrome: prevelance, causes and therapeutic consequences. Eur Respir J . 1996; 9 787-794
14 Bradley T D, Rutherford R, Grossmann R F. et al . Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis . 1985; 131 835-839
15 Podszus T, Bauer W, Mayer J, Penzel T, Peter J H, Wichert P. Sleep apnea and pulmonary hypertension. Klin Wschr . 1986; 64 131-134
16 Weitzenblum E, Kreiger J, Apprill M. et al . Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis . 1988; 138 345-349
17 Krieger J, Sforza E, Apprill M. et al . Pulmonary hypertension, hypoxemia and hypercapnia in obstructive sleep apnea patients. Chest . 1989; 96 729-737
18 Laks L, Lehrharft B, Grunstein R R. et al . Pulmonary hypertension in obstructive sleep apnea. Eur Respir J . 1995; 8 537-541
19 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
20 Fletcher E C, Schaaf J M, Miller J, Fletcher J G. Long-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease. Am Rev Respir Dis . 1987; 135 525-533
21 Sajkov D, Cowie R J, Thornton A T, Espinoza H, McEvoy R D. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med . 1994; 149 416-422
22 Shinozaki T, Tatsumi K, Sakuma T. et al . Daytime pulmonary hypertension in the obstructive sleep apnea syndrome. Japanese Journal of Thoracic Diseases . 1995; 33 1073-1079
23 Hawrylkiewicz I, Sliwinski P, Palasiewicz G, Plywaczewski R, Zielinski J. Effect of nocturnal hypoxia on pulmonary hemodynamics in patients with obstructive sleep apnea syndrome. Pneumonologia I Alergologia Polska . 2000; 68 28-36
24 Sajkov D, Wang T, Saunders N A, Bune A J, Neill A M, McEvoy R D. Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med . 1999; 159 1518-1526
25 Sanner B M, Doberauer C, Konermann M, Sturm A, Zidek W. Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med . 1997; 157 2483-2487
26 Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban J P. Pulmonary arterial hypertension in patients with obstructive sleep apnea syndrome. Thorax . 2000; 55 934-939
27 Sanner B M, Konermann M, Sturm A, Müller, Zidek W. Right ventricular function in patients with obstructive sleep apnoea syndrome. Eur Respir J . 1997; 10 2079-2083
28 Noda A, Okada T, Yasuma F, Nakashima N, Yokota M. Cardiac hypertrophy in obstructive sleep apnea syndrome. Chest . 1995; 107 1538-1544
29 Guidry U C, Mendes L A, Evans J C. et al . Echocardiographic features of the right heart in sleep-disordered breathing. Am J Respir Crit Care Med . 2001; 164 933-938
30 Sforza E, Krieger J, Weitzenblum E, Apprill M, Lampert E, Ratomaharo J. Long-term effects of treatment with nasal continuous positive airway pressure on daytime lung function and pulmonary hemodynamics in patients with obstructive sleep apnea. Am Rev Respir Dis . 1990; 141 866-870
31 Chaouat A, Weitzenblum E, Kessler R. et al . Five-year effects of nasal continuous positive airway pressure in obstructive sleep apnoea syndrome. Eur Respir J . 1997; 10 2578-2582
32 Sajkov D, Wang T, Saunders N A, Bune A J, McEvoy R D. Continuous positive airway pressure treatment improves pulmonary hemodynamics in patients with obstructive sleep apnea. Am J Respir Crit Care Med . 2002; 165 152-158