Heart failure and sleep disorders

Gianfranco Parati, Carolina Lombardi, Francesco Castagna, Paola Mattaliano, Pasquale Perrone Filardi, Piergiuseppe Agostoni

Research output: Contribution to journalArticle

Abstract

Awareness of the importance of sleep-related disorders in patients with cardiovascular diseases is growing. In particular, sleep-disordered breathing, short sleep time, and low sleep quality are frequently reported by patients with heart failure (HF). Sleep-disordered breathing, which includes obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), is common in patients with HF and has been suggested to increase the morbidity and mortality in these patients. Both OSA and CSA are associated with increased sympathetic activation, vagal withdrawal, altered haemodynamic loading conditions, and hypoxaemia. Moreover, OSA is strongly associated with arterial hypertension, the most common risk factor for cardiac hypertrophy and failure. Intrathoracic pressure changes are also associated with OSA, contributing to haemodynamic alterations and potentially affecting overexpression of genes involved in ventricular remodelling. HF treatment can decrease the severity of both OSA and CSA. Indeed, furosemide and spironolactone administration, exercise training, cardiac resynchronization therapy, and eventually heart transplantation have shown a positive effect on OSA and CSA in patients with HF. At present, whether CSA should be treated and, if so, which is the optimal therapy is still debated. By contrast, more evidence is available on the beneficial effects of OSA treatment in patients with HF.

Original languageEnglish
JournalNature Reviews Cardiology
DOIs
Publication statusAccepted/In press - May 12 2016

Fingerprint

Obstructive Sleep Apnea
Central Sleep Apnea
Heart Failure
Sleep Apnea Syndromes
Sleep
Hemodynamics
Cardiac Resynchronization Therapy
Spironolactone
Ventricular Remodeling
Furosemide
Cardiomegaly
Heart Transplantation
Sleep Wake Disorders
Cardiovascular Diseases
Therapeutics
Exercise
Hypertension
Morbidity
Pressure
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Heart failure and sleep disorders. / Parati, Gianfranco; Lombardi, Carolina; Castagna, Francesco; Mattaliano, Paola; Filardi, Pasquale Perrone; Agostoni, Piergiuseppe.

In: Nature Reviews Cardiology, 12.05.2016.

Research output: Contribution to journalArticle

Parati, Gianfranco ; Lombardi, Carolina ; Castagna, Francesco ; Mattaliano, Paola ; Filardi, Pasquale Perrone ; Agostoni, Piergiuseppe. / Heart failure and sleep disorders. In: Nature Reviews Cardiology. 2016.
@article{483d220634e946b291fb3c6c0dfc0b27,
title = "Heart failure and sleep disorders",
abstract = "Awareness of the importance of sleep-related disorders in patients with cardiovascular diseases is growing. In particular, sleep-disordered breathing, short sleep time, and low sleep quality are frequently reported by patients with heart failure (HF). Sleep-disordered breathing, which includes obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), is common in patients with HF and has been suggested to increase the morbidity and mortality in these patients. Both OSA and CSA are associated with increased sympathetic activation, vagal withdrawal, altered haemodynamic loading conditions, and hypoxaemia. Moreover, OSA is strongly associated with arterial hypertension, the most common risk factor for cardiac hypertrophy and failure. Intrathoracic pressure changes are also associated with OSA, contributing to haemodynamic alterations and potentially affecting overexpression of genes involved in ventricular remodelling. HF treatment can decrease the severity of both OSA and CSA. Indeed, furosemide and spironolactone administration, exercise training, cardiac resynchronization therapy, and eventually heart transplantation have shown a positive effect on OSA and CSA in patients with HF. At present, whether CSA should be treated and, if so, which is the optimal therapy is still debated. By contrast, more evidence is available on the beneficial effects of OSA treatment in patients with HF.",
author = "Gianfranco Parati and Carolina Lombardi and Francesco Castagna and Paola Mattaliano and Filardi, {Pasquale Perrone} and Piergiuseppe Agostoni",
year = "2016",
month = "5",
day = "12",
doi = "10.1038/nrcardio.2016.71",
language = "English",
journal = "Nature Reviews Cardiology",
issn = "1759-5002",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Heart failure and sleep disorders

AU - Parati, Gianfranco

AU - Lombardi, Carolina

AU - Castagna, Francesco

AU - Mattaliano, Paola

AU - Filardi, Pasquale Perrone

AU - Agostoni, Piergiuseppe

PY - 2016/5/12

Y1 - 2016/5/12

N2 - Awareness of the importance of sleep-related disorders in patients with cardiovascular diseases is growing. In particular, sleep-disordered breathing, short sleep time, and low sleep quality are frequently reported by patients with heart failure (HF). Sleep-disordered breathing, which includes obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), is common in patients with HF and has been suggested to increase the morbidity and mortality in these patients. Both OSA and CSA are associated with increased sympathetic activation, vagal withdrawal, altered haemodynamic loading conditions, and hypoxaemia. Moreover, OSA is strongly associated with arterial hypertension, the most common risk factor for cardiac hypertrophy and failure. Intrathoracic pressure changes are also associated with OSA, contributing to haemodynamic alterations and potentially affecting overexpression of genes involved in ventricular remodelling. HF treatment can decrease the severity of both OSA and CSA. Indeed, furosemide and spironolactone administration, exercise training, cardiac resynchronization therapy, and eventually heart transplantation have shown a positive effect on OSA and CSA in patients with HF. At present, whether CSA should be treated and, if so, which is the optimal therapy is still debated. By contrast, more evidence is available on the beneficial effects of OSA treatment in patients with HF.

AB - Awareness of the importance of sleep-related disorders in patients with cardiovascular diseases is growing. In particular, sleep-disordered breathing, short sleep time, and low sleep quality are frequently reported by patients with heart failure (HF). Sleep-disordered breathing, which includes obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), is common in patients with HF and has been suggested to increase the morbidity and mortality in these patients. Both OSA and CSA are associated with increased sympathetic activation, vagal withdrawal, altered haemodynamic loading conditions, and hypoxaemia. Moreover, OSA is strongly associated with arterial hypertension, the most common risk factor for cardiac hypertrophy and failure. Intrathoracic pressure changes are also associated with OSA, contributing to haemodynamic alterations and potentially affecting overexpression of genes involved in ventricular remodelling. HF treatment can decrease the severity of both OSA and CSA. Indeed, furosemide and spironolactone administration, exercise training, cardiac resynchronization therapy, and eventually heart transplantation have shown a positive effect on OSA and CSA in patients with HF. At present, whether CSA should be treated and, if so, which is the optimal therapy is still debated. By contrast, more evidence is available on the beneficial effects of OSA treatment in patients with HF.

UR - http://www.scopus.com/inward/record.url?scp=84966470625&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84966470625&partnerID=8YFLogxK

U2 - 10.1038/nrcardio.2016.71

DO - 10.1038/nrcardio.2016.71

M3 - Article

JO - Nature Reviews Cardiology

JF - Nature Reviews Cardiology

SN - 1759-5002

ER -