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sleep-disordered breathing is associated with depletion of circulating endothelial progenitor cells and elevation in pulmonary arterial pressure in patients with decompensated systolic heart failure

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Journal of Geriatric Cardiology 2015年第4期12卷 424-430页

作者： Han ZHANG Liu FENG Qi-Lin WAN Yan HONG Yan-Ming LI Guan-Chang CHENG Xin-Qiang HAN Department of Cardiology Huaihe Hospital of Henan University No.8 Baogonghu Road Kaifeng Henan China Department of Intensive Care Unit Huaihe Hospital of Henan University No.8 Baogonghu Road Kaifeng Henan China Reid Hospital and Health Care Services Indiana University School of Medicine Richmond USA

Background sleep-disordered breathing （SDB） is known to occur frequently in and may predict worsening progression of patients with congestive heart failure （CHF）. SDB is also known to play an important role in the development of idiopathic pulmonary arterial hyper- tension （PAH） via inducing endothelial dysfunction and vascular remodeling, a pathological process that can be significantly influenced by factors such as osteoprotegerin （OPG） and endothelial progenitor cells （EPCs）. The objective of this study is to determine if CHF with SDB is associated with changes in OPG, EPCs, and PAIl. Methods EPCs were isolated, cultured, and quantified from CHF patients with SDB （n = 52）, or without SDB （n - 68）. OPG and N-terminal pro-brain natriuretic peptide （NT-proBNP） from each group was analyzed and cor- related with EPCs and the mean pulmonary artery pressure （mPAP） measured by right heart catheterization. Results A significant decrease in circulating EPCs （29.30 ± 9.01 vs. 45.17 ± 10.51 EPCs/x 200 field; P 〈 0.05） was found in CHF patients with SDB compared to those without SDB. Both OPG （789.83 ±89.38 vs. 551.29 ± 42.12 pg/mL; P 〈 0.05） and NT-proBNP （5946.50 ± 1434.50 vs. 3028.60 ± 811.90 ng/mL; P 〈 0.05） were also significantly elevated in SDB CHF patients who also had significantly elevated mPAP （50.2 ± 9.5 vs. 36.4 ± 4.1 mm Hg; P 〈 0.05）. EPC numbers correlated inversely with the episodes of apnea and hypopnea per hour （RDI, r = -0.45, P = 0.037） and blood level of OPG （r =-0.53, P = 0.011）. Although NT-proBNP was also increased significantly in patients with SDB, it had no correlation with either EPCs or RD1. Conclusions SDBdue to hypoxemia from decompensated CHF is associated with （1） OPG elevation, （2） EPC depletion, and （3） mPAP elevation. The inverse relationship of circulating OPG with EPCs suggests a likely mechanism for hypoxemia and OPG in the development of pulmonary vascular dysfunction via depleting EPCs, thus worsening prognosis of CHF.

关键词： Congestive heart failure Endothelial progenitor cells Osteoprotegerin sleep-disordered breathing

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Nocturnal myocardial ischemic events and sleep-disordered breathing in patients with coronary artery disease

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Journal of Geriatric Cardiology 2004年第2期1卷 90-94页

作者： Wenli ZHANG Shiwen WANG Caiyi LU Peng LIU Rui CHEN Xian JI Yusheng ZHAO Institute of Geriatric Cardiology Chinese PLA General Hospital Beijing 100853 China

Objective To investigate the occurrence of nocturnal myocardial ischemia and its relationship with sleep-disordered breathing (apneas and oxygen desaturations) in patients with angina pectoris undergoing coronary *** Eighty-two men and 14 women referred for consideration of coronary intervention were randomly selected. Observation by an overnight sleep monitor and Holter recording were performed to study sleep-disordered breathing (oxyhemoglobin desaturations≥4% and apnea-hypopneas),heart rates, and ST-segment depressions (≥ 1mm, ≥1 min).Results Nocturnal ST-segment depressions occurred in 37 % of the patients. ST-segment depression within 2 min after an apnea-hypopnea or desaturation occurred in 17% of the patients. This temporal association was seen in 21% of the patients with nocturnal ST-segment depressions, more frequently in men (Pdisordered breathing (Pbreathing events: repeated apnea-hypopneas or desaturations or both in 73% of the patients. Conclusions Episodes of nocturnal myocardial ischemia are common in patients with angina pectoris. A temporal relationship between sleep-disordered breathing and myocardial ischemia was present in some of our patients, and occurs more frequently in men and in those with severely disordered breathing. (J Geriatr Cardiol 2004;1(2):90-94.)

关键词： angina pectoris myocardial ischemia coronary artery disease sleep-disordered breathing

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Characteristics of Electroencephalogram Arousals of sleep- disordered breathing Children at Different sleep Stages

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Chinese Medical Journal 2016年第23期129卷 2876-2878页

作者： Da-Bo Liu Yu-Jing Yao Zhen-Yun Huano Jian-Wen Zhong Jia-Jian Xu Shu-Yao Qiu Shao-Feng Liu Xin-Hua Yi Department of Otolaryngology Guangzhou Women and Children's Medical Center The Affiliated Guangzhou Women and Children's Medical Center of Guangzhou Medical University Guangzhou Guangdong 510120 China

sleep-disordered breathing （SDB） is the most common sleep- related disorder, and it can seriously affect sleep conditions, growth, and neurocognitive function. Recent research even demonstrates that hypertensive pat... 详细信息

关键词： Electroencephalogram Arousals Limb Arousal Index Primary Snoring Respiratory Arousal Index sleep-disordered breathing Spontaneous Arousal Index

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sleep disorders in Alzheimer’s disease:the predictive roles and potential mechanisms

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Neural Regeneration Research 2021年第10期16卷 1965-1972页

作者： Huang Kuang Yu-Ge Zhu Zhi-Feng Zhou Mei-Wen Yang Fen-Fang Hong Shu-Long Yang Department of Physiology College of MedicineNanchang UniversityNanchangJiangxi ProvinceChina Department of Nurse Nanchang University HospitalNanchangJiangxi ProvinceChina Department of Experimental Teaching Center Nanchang UniversityNanchangJiangxi ProvinceChina

sleep disorders are common in patients with Alzheimer’s disease,and can even occur in patients with amnestic mild cognitive impairment,which appears before Alzheimer’s *** disorders further impair cognitive function and accelerate the accumulation of amyloid-βand tau in patients with Alzheimer’s *** present,sleep disorders are considered as a risk factor for,and may be a predictor of,Alzheimer’s disease *** that sleep disorders are encountered in other types of dementia and psychiatric conditions,sleep-related biomarkers to predict Alzheimer’s disease need to have high specificity and ***,we summarize the major Alzheimer’s disease-specific sleep changes,including abnormal non-rapid eye movement sleep,sleep fragmentation,and sleep-disordered breathing,and describe their ability to predict the onset of Alzheimer’s disease at its earliest *** the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer’s *** paper therefore explores some potential mechanisms that may contribute to sleep disorders,including dysregulation of the orexinergic,glutamatergic,andγ-aminobutyric acid systems and the circadian rhythm,together with amyloid-β*** review could provide a theoretical basis for the development of drugs to treat Alzheimer’s disease based on sleep disorders in future work.

关键词： Alzheimer’s disease amyloid-βaccumulation circadian rhythm GABAergic system glutamatergic system non-rapid eye movement sleep orexinergic system sleep disorders sleep fragmentation sleep-disordered breathing

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Dilated cardiomyopathy is associated with increased prevalence of sleep apnea

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South China Journal of Cardiology 2016年第4期17卷 210-216页

作者：梁颖聪王玲王锐罗建方陈纪言周颖玲张佳玮 Department of Cardiology Guangdong Provincial Cardiovascular InstituteGuangdong General HospitalGuangdong Academy of Medical Sciences

Background sleep apnea（SA） is a common disorder in general population, especially cardiovascular disease （CVD） patients. However, its role in cardiomyopathy etiology is still unclear. Methods In this single-center observational study, we enrolled 2740 CVD patients consecutively from 2013 to 2016. Among study subjects, 65 were diagnosed as idiopathic dilated cardiomyopathy（DCM） and 34 were hypertrophic cardiomyopathy（HCM）. Patients underwent sleep study with portable monitoring devices and diagnosed as non-SA （AHI〈5）, mild （5-≤ AHI≤15）, moderate （15〈AHI≤30） or severe SA （AHI〉30） using the apnea-hypopnea index （AHI）. Central sleep apnea（CSA） and obstructive sleep apnea（OSA） were defined by central event percentage, with 50% as cut-value. Results The prevalence of SA was higher in DCM patients. While the prevalence of moderate to severe SA was similar in HCM and other CVD patients （32.4% vs. 34.3%, P 〉0.1）, it was significantly higher in DCM patients （49.2%, P =0.017 vs. other CVD patients）. The prevalence of CSA in DCM patients was also higher than other CVD patients （9.2% vs. 3.2%, P〈0.01）, but the difference of OSA was not statistically significant （40.0% vs. 30.3%, P =0.229）. In comparison to other heart failure with reduced ejection fraction （HFrEF） patients, the result was nearly at the same level. Conclusions SA is more common in idiopathic dilated cardiomyopathy patients. Prevalence of moderate to severe SA and CSA is higher in idiopathic HCM patients than other CVD and HFrEF patients.

关键词： dilated cardiomyopathy sleep-disordered breathing cardiovascular disease hypertrophic cardiomyopathy

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Validation of the Nox-T3 Portable Monitor for Diagnosis of Obstructive sleep Apnea in Community-living polio survivors

Validation of the Nox-T3 Portable Monitor for Diagnosis of O...

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中国睡眠研究会第十四届全国学术年会

作者： Qidi Ding Jianghua Liu Jinxian Wu Juan Du Chi Zhang Fang Han Peking University People's Hospital Binzhou Medical University Hospita Dongyang People’s Hospital Dongyang the Seventh People’s Hospital

Background: sleep-disordered breathing(SDB) is highly prevalent in polio survivors. Obstructive sleep apnea syndrome(OSAS) was the main type. Full polysomnography(PSG) is the gold standard for SDB diagnosis, but not always accessible. The purpose of the current study was to evaluate whether a type 3 portable monitors(PM) might be a viable alternative to PSG for the diagnosis of OSAS in community-living post-polio subjects. Methods: Community-living post-polio subjects were recruited. First, they completed Epworth sleepiness Scale(ESS) questionnaire, took pulmonary function testing and blood gas test the day before PSG night. Then they performed an overnight in-laboratory PSG with a simultaneous PM recording. Sensitivity and specificity were calculated for standard apnea hypopnea Index(AHI) cut-offs for mild(≥5/h), moderate(≥15/h) and severe OSAS(≥30/h). Correlation plots were constructed to visually compare respiratory disorder index(RDI) and oxygen desaturation index(ODI) from PM vs. AHI from PSG. Bland-Altman plots were also used to compare consistence between the paired RDI and AHI. Receiver operating characteristic(ROC) curves were constructed for RDI and ODI from PM, at AHI thresholds of 15/***: For AHI ≥5/h, RDI sensitivity and specificity were 95.45% and 50% respectively. For AHI ≥ 15/h, RDI sensitivity and specificity were 87.88% and 93.33%%. The Bland-Altman analysis of AHI on PSG versus RDI on PM showed a mean difference of 5.09(95% confidence interval [CI]: 3.08, 7.10;P 15/h showed an area under the curve(AUC) of 0.97, 95% CI: ***: The NOX-T3 are of primary diagnostic value for OSAS in postpolio patients. However, the diagnostic value of PM for patients with alveolar hypoventilation requires further research.

关键词： sleep-disordered breathing Obstructive sleep apnea syndrome postpolio portable monitor

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