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Macrì R, Mollace R, Serra M, Scarano F, Ritorto G, Ussia S, Cardamone A, Coppoletta AR, Carresi C, Gliozzi M, Musolino V, Maiuolo J, Palma E, Volterrani M, Mollace V, Muscoli C. Nutritional and Nutraceutical Support to the Failing Myocardium: A Possible Way of Potentiating the Current Treatment of Heart Failure. Int J Mol Sci 2024; 25:12232. [PMID: 39596298 PMCID: PMC11594499 DOI: 10.3390/ijms252212232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 11/06/2024] [Accepted: 11/12/2024] [Indexed: 11/28/2024] Open
Abstract
Heart failure (HF) is a complex condition that affects 1-2% of the global population. The presence of comorbidities like diabetes, hypertension, hyperlipidemia, or obesity has been shown in various studies to elevate mortality and hospitalization rates in HF patients. Insufficient outcomes persist in HF, necessitating additional research to address unmet needs in disease management. Lifestyle modifications, including smoking cessation, decreased alcohol consumption, regular exercise, cardiac rehabilitation, and a balanced diet, can prevent and treat a wide range of HF cases. In this review, we aimed to examine how lifestyle changes, nutrition, and nutraceutical supplements can play a role in preventing heart failure and supporting its treatment. A detailed and comprehensive analysis of the most recent data present in the literature could help identify potential candidates for future clinical trials in HF management. There is a growing body of evidence supporting the importance of closely monitoring nutritional balance, including micronutrients and nutraceuticals, in HF patients for better symptom management and outcomes. Despite promising results from initial approaches, the lack of conclusive evidence from recent studies and meta-analyses questions the widespread use of nutraceutical supplementation in HF patients. Further studies are necessary to determine the most effective way to use nutraceutical supplementation in the treatment of myocardial dysfunction in HF patients.
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Affiliation(s)
- Roberta Macrì
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Rocco Mollace
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
- Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Rome, Italy
| | - Maria Serra
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Federica Scarano
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Giovanna Ritorto
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Sara Ussia
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Antonio Cardamone
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Anna Rita Coppoletta
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Cristina Carresi
- Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (C.C.); (E.P.)
| | - Micaela Gliozzi
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy; (V.M.); (J.M.)
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario di Germaneto, 88100 Catanzaro, Italy; (V.M.); (J.M.)
| | - Ernesto Palma
- Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (C.C.); (E.P.)
| | | | - Vincenzo Mollace
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
- Renato Dulbecco Institute, Lamezia Terme, 88046 Catanzaro, Italy
| | - Carolina Muscoli
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (M.S.); (F.S.); (G.R.); (S.U.); (A.C.); (A.R.C.); (M.G.); (V.M.); (C.M.)
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Menon T, Ogbu I, Kalra DK. Sleep-Disordered Breathing and Cardiac Arrhythmias. J Clin Med 2024; 13:6635. [PMID: 39597779 PMCID: PMC11595083 DOI: 10.3390/jcm13226635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 10/29/2024] [Accepted: 10/31/2024] [Indexed: 11/29/2024] Open
Abstract
A narrative review was performed, analyzing peer-reviewed articles from databases such as PubMed, EMBASE, Scopus, and Web of Science to examine the mechanistic links between sleep-disordered breathing (SDB), and cardiac arrhythmias, emphasizing intermittent hypoxia, autonomic imbalance, and intrathoracic pressure swings as key pathways. Studies, including the DREAM and CESAAR trials, consistently demonstrate that SDB patients face elevated risks: more than doubling the likelihood of overall arrhythmias (OR 2.24; 95% CI 1.48-3.39), quadrupling the risk of AF (OR 4.02; 95% CI 1.03-15.74), and tripling the risk of non-sustained ventricular tachycardia (NSVT) with higher apnea-hypopnea index (AHI) values. Additionally, SDB doubles the risk of bradyarrhythmia, such as sinus pause, second and third-degree atrioventricular block, and intraventricular conduction delay (OR 2.50; 95% CI 1.58-3.95). According to meta-analytical findings, continuous positive airway pressure (CPAP) therapy is a pivotal intervention, significantly reducing AF recurrence by 42% and lowering VA incidence by 58%. Moreover, CPAP therapy diminishes sinus bradycardia and occurrences of sinus pause and may reduce the necessity for pacemaker implantation. Recognizing SDB as a modifiable risk factor for cardiac arrhythmias highlights the importance of early diagnosis and effective management, primarily through CPAP therapy, to improve cardiovascular outcomes.
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Affiliation(s)
| | | | - Dinesh K. Kalra
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA; (T.M.); (I.O.)
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Alhabeeb W, Kinsara AJ, Bakhsh A, Tash A, Alshammary A, Almasood A, Alghalayini K, Arafah M, Hamdy O, Alsifri S, Kharabsheh SM, Alkattan W. A Saudi Heart Association Position Statement on Obesity and Cardiovascular Disease. J Saudi Heart Assoc 2024; 36:263-300. [PMID: 39469000 PMCID: PMC11518015 DOI: 10.37616/2212-5043.1391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/29/2024] [Accepted: 08/06/2024] [Indexed: 10/30/2024] Open
Abstract
OBJECTIVES The obesity pandemic is a major public health concern in Saudi Arabia, with significant impact on cardiovascular disease (CVD). This position statement aims to provide an overview of available evidence as well as the recommendations of the Saudi Heart Association on the management of obesity associated with CVD. METHODS Under the auspices of the Saudi Heart Association, a multidisciplinary expert panel comprised of cardiologists and endocrinologists discussed available evidence and provided recommendations on the management of obesity in CVD. The expert panel discussions occurred between September of 2023 and May of 2024 and also took into consideration local expertise in addition to published data in the management of obesity and CVD in the Kingdom of Saudi Arabia. RESULTS AND CONCLUSIONS The expert panel explored studies on obesity and its implication on CVD assessment modalities, while also examining the efficacy and cardiovascular safety of available interventions for weight reduction. The association between obesity and CVD is undeniable. The treatment of obesity, be it through lifestyle changes, pharmacological therapy or surgery, is an effective strategy for both weight loss as well as the primary and secondary prevention of CVD. The Saudi Heart Association position statement thus provides guidance and recommendations for the management of obesity/overweight and CVD in Saudi Arabia. This position statement is expected to contribute towards obesity and CVD prevention efforts in Saudi Arabia by promoting adequate and time-appropriate treatment of these conditions.
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Affiliation(s)
- Waleed Alhabeeb
- Department of Cardiac Sciences, King Saud University, Riyadh,
Saudi Arabia
| | - Abdulhalim J. Kinsara
- Ministry of National Guard Health Affairs, Jeddah,
Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, COM-WR, Jeddah,
Saudi Arabia
- Department of Cardiology, King Abdullah International Research Center, Jeddah,
Saudi Arabia
| | - Abeer Bakhsh
- Department of Cardiology, Prince Sultan Cardiac Centre, Riyadh,
Saudi Arabia
| | - Adel Tash
- National Heart Center, Saudi Health Council, Riyadh,
Saudi Arabia
| | - Afaf Alshammary
- Diabetes Center, King Abdulaziz Medical City, Riyadh,
Saudi Arabia
| | - Ali Almasood
- Department of Cardiology, Specialized Medical Center Riyadh,
Saudi Arabia
| | - Kamal Alghalayini
- Department of Cardiology, King Abdulaziz University Hospital, Jeddah,
Saudi Arabia
| | - Mohammed Arafah
- Department of Cardiac Sciences, King Saud University, Riyadh,
Saudi Arabia
| | - Osama Hamdy
- Joslin Diabetes Center, Harvard Medical School, Boston, MA,
USA
| | - Saud Alsifri
- Department of Endocrinology, Alhada Armed Forces Hospital, Taif,
Saudi Arabia
| | - Suleiman M. Kharabsheh
- Director of the CCU and Telemetry Units, King Faisal Specialist Hospital & Research Centre, Riyadh,
Saudi Arabia
| | - Wail Alkattan
- Department of Cardiology, King Faisal Specialist Hospital & Research Centre, Riyadh,
Saudi Arabia
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Wolsing SK, Frølund JC, Dalgård C, Hilberg O, Gantzhorn E. Telephone follow-up as a substitute for standard out-clinic follow-up in CPAP therapy for obstructive sleep apnea patients: a randomized controlled trial. Sleep Breath 2024; 28:1651-1659. [PMID: 38720151 PMCID: PMC11303568 DOI: 10.1007/s11325-024-03045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/29/2024] [Accepted: 04/26/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE This study assessed the feasibility of telephone follow-up consultations (TC) using an online data sharing and editing function (Airview™), as alternative to standard out-clinic follow-up consultations (SC) on adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. Furthermore, we investigated compliance to follow-up consultations and examined potential influencing factors, including baseline AHI (apnea-hypopnea-index), age, and distance from home to the hospital on consultation compliance. METHODS Two hundred OSA patients, with AHI ≥ 5 were randomly assigned (1:1) to receive TC or SC with follow-up after one month and 12 month of CPAP initiation. Adherence goal was defined as achieving ≥ 4 h of CPAP use daily in 70% of the days in a 365-days period. RESULTS The proportion of participants achieving CPAP adherence was non-significantly lower in the TC group compared to the SC group (TC: 30% versus SC: 36%, adjusted OR 0.84, p = 0.59). Of participants who completed the study, the TC group had a significant average of 107 min less use of CPAP compared to the SC group (p = 0.048). However, a higher proportion of participants was compliant to consultations in the TC group. The only influencing factor found was increasing baseline AHI, which might be a predictor for compliance to consultations and adherence to CPAP therapy. CONCLUSION TC might serve as substitute for SC in some part of the OSA population. If TC becomes a part of CPAP therapy management, it is important to consider patient characteristics and treatment-related issues to prevent decline in adherence.
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Affiliation(s)
- Sofie Krogh Wolsing
- Department of Medicine, Lillebaelt Hospital, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Jannie Christina Frølund
- Department of Medicine, Lillebaelt Hospital, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Christine Dalgård
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Ole Hilberg
- Department of Medicine, Lillebaelt Hospital, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Eline Gantzhorn
- Department of Medicine, Lillebaelt Hospital, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
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Prechaporn W, Hantrakul P, Ngamjarus C, Sukeepaisarnjaroen W, Sawanyawisuth K, Khamsai S. Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review and meta-analysis. Heart Fail Rev 2024; 29:811-826. [PMID: 38722388 DOI: 10.1007/s10741-024-10399-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 06/19/2024]
Abstract
Obstructive sleep apnea (OSA) is a disease with intermittent hypoxemia during sleep. It has been shown that OSA is related to several cardiovascular diseases including heart failure. Both OSA and heart failure have a close association bidirectionally. This study aimed to estimate the pooled prevalence of OSA in patients with heart failure as well as pooled prevalence of heart failure in patients with OSA. This was a systematic review with a meta-analysis. The inclusion criteria were observational or epidemiological studies conducted in adult patients with heart failure to evaluate the prevalence of OSA and patients with OSA to evaluate the prevalence of heart failure. The outcomes of this study were prevalence of OSA in patients with heart failure and prevalence of heart failure in patients with OSA. Four databases were used for systematic searching including PubMed, Science Direct, Scopus, and CINAHL Plus. Manual searches for related studies were also conducted. Proportion meta-analyses using a random-effects model were conducted to identify pooled proportion (prevalence) of heart failure in patients with OSA and vice versa. Among 3,941 articles from the four databases met the study criteria. Thirty-three studies showed the prevalence of OSA in patients with heart failure, while thirteen studies presented the prevalence of heart failure in patients with OSA. The prevalence of OSA in patients with heart failure was 38.4% (95% CI 31.9 to 45.2; I2 of 96.1%). Using a diagnostic criterion of OSA of more than 10 events/hr had the highest prevalence of OSA in patients with heart failure at 53.4% (95% CI 42.0 to 64.5). The highest prevalence of OSA in patients with heart failure was 60.1% (95% CI 51.4 to 68.3) in a report from India. The pooled prevalence of heart failure in patients with OSA was 12.8% (95% CI 8.1 to 19.5; I2 of 94.6%). The prevalence in Romania was highest at 22.6% (95% CI 20.4 to 24.9). The pooled prevalence of OSA in patients with heart failure was higher than the pooled prevalence of heart failure in patients with OSA. The pooled prevalence rates of these associations varied among the diagnostic criteria of OSA and countries.
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Affiliation(s)
- Wisarud Prechaporn
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Phasu Hantrakul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Menon T, Kalra DK. Sleep Apnea and Heart Failure-Current State-of-The-Art. Int J Mol Sci 2024; 25:5251. [PMID: 38791288 PMCID: PMC11121476 DOI: 10.3390/ijms25105251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Sleep-disordered breathing (SDB), including obstructive and central sleep apnea, significantly exacerbates heart failure (HF) through adverse cardiovascular mechanisms. This review aims to synthesize existing literature to clarify the relationship between SDB and HF, focusing on the pathophysiological mechanisms, diagnostic challenges, and the effectiveness of treatment modalities like continuous positive airway pressure (CPAP) and adaptive servo-ventilation ASV. We analyzed peer-reviewed articles from 2003 to 2024 sourced from PubMed, EMBASE, Scopus, and Web of Science databases. The prevalence of SDB in HF patients is high, often underdiagnosed, and underappreciated. Management strategies, including CPAP and ASV, have been shown to mitigate symptoms and improve cardiac function. However, despite the availability of effective treatments, significant challenges in screening and diagnosis persist, affecting patient management and outcomes. DB significantly impacts HF prognosis. Enhanced screening strategies and broader utilization of therapeutic interventions like CPAP and ASV are essential to improve the management and outcomes of HF patients with concomitant SDB. Future research should focus on refining diagnostic and treatment protocols to optimize care for HF patients with SDB.
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Affiliation(s)
- Tushar Menon
- Division of Cardiology, University of Louisville Hospital, 201 Abraham Flexner Way, Suite 600, Louisville, KY 40202, USA
| | - Dinesh K. Kalra
- Division of Cardiology, University of Louisville Hospital, 201 Abraham Flexner Way, Suite 600, Louisville, KY 40202, USA
- Lipid Clinic & Infiltrative Heart Disease Program, Rudd Heart & Lung Center, Division of Cardiovascular Medicine, Department of Medicine, University of Louisville School of Medicine, 201 Abraham Flexner Way, Suite 600, Louisville, KY 40202, USA
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7
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Armentaro G, Pelaia C, Condoleo V, Severini G, Crudo G, De Marco M, Pastura CA, Tallarico V, Pezzella R, Aiello D, Miceli S, Maio R, Savarese G, Rosano GMC, Sciacqua A. Effect of SGLT2-Inhibitors on Polygraphic Parameters in Elderly Patients Affected by Heart Failure, Type 2 Diabetes Mellitus, and Sleep Apnea. Biomedicines 2024; 12:937. [PMID: 38790899 PMCID: PMC11117816 DOI: 10.3390/biomedicines12050937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
Obstructive sleep apneas (OSAs) and central sleep apneas (CSAs) are the most common comorbidities in Heart Failure (HF) that are strongly associated with all-cause mortality. Several therapeutic approaches have been used to treat CSA and OSA, but none have been shown to significantly improve HF prognosis. Our study evaluated the effects of a 3-months treatment with sodium-glucose cotransporter type 2 inhibitor (SGLT2i) on polygraphic parameters in patients with sleep apnea (SA) and HF, across the spectrum of ejection fraction, not treated with continuous positive air pressure (CPAP). A group of 514 consecutive elderly outpatients with HF, type 2 diabetes mellitus (T2DM) and SA, eligible for treatment with SGLT2i, were included in the investigation before starting any CPAP therapy. The two groups were compared with the t-test and Mann-Whitney test for unpaired data when appropriate. Then, a simple logistic regression model was built using 50% reduction in AHI as the dependent variable and other variables as covariates. A multivariate stepwise logistic regression model was constructed using the variables that linked with the dependent variable to calculate the odds ratio (OR) for the independent predictors associated with the reduction of 50% in AHI. The treated group experienced significant improvements in polygraphic parameters between baseline values and follow-up with reduction in AHI (28.4 ± 12.9 e/h vs. 15.2 ± 6.5 e/h; p < 0.0001), ODI (15.4 ± 3.3 e/h vs. 11.1 ± 2.6 e/h; p < 0.0001), and TC90 (14.1 ± 4.2% vs. 8.2 ± 2.0%; p < 0.0001), while mean SpO2 improved (91. 3 ± 2.3 vs. 93.8 ± 2.5); p < 0.0001. These benefits were not seen in the untreated population. The use of SGLT2i in patients suffering from HF and mixed-type SA not on CPAP therapy significantly contributes to improving polygraphic parameters.
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Affiliation(s)
- Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Valentino Condoleo
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Giandomenico Severini
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Giulia Crudo
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Mario De Marco
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Carlo Alberto Pastura
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | | | - Rita Pezzella
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy;
| | - Domenico Aiello
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
| | - Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Giuseppe M. C. Rosano
- Department of Human Sciences and Promotion of Quality of Life, Chair of Pharmacology, San Raffaele University of Rome, 00166 Rome, Italy;
- Cardiology, San Raffaele Cassino Hospital, 03043 Cassino, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Campus Universitario “S. Venuta”, Viale Europa—Località Germaneto, 88100 Catanzaro, Italy; (G.A.); (C.P.); (V.C.); (G.S.); (G.C.); (M.D.M.); (C.A.P.); (S.M.); (R.M.)
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8
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Ghaderi S, Mohammadi S, Mohammadi M. Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments. Brain Behav 2023; 13:e3262. [PMID: 37743582 PMCID: PMC10636416 DOI: 10.1002/brb3.3262] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Obstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients. METHODS We searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits. RESULTS We included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings. CONCLUSIONS We found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.
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Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction StudiesSchool of Advanced Technologies in MedicineTehran University of Medical SciencesTehranIran
| | - Sana Mohammadi
- Department of Medical SciencesSchool of MedicineIran University of Medical SciencesTehranIran
| | - Mahdi Mohammadi
- Department of Medical Physics and Biomedical Engineering, School of MedicineTehran University of Medical SciencesTehranIran
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Guzik M, Urban S, Iwanek G, Biegus J, Ponikowski P, Zymliński R. Novel Therapeutic Devices in Heart Failure. J Clin Med 2022; 11:4303. [PMID: 35893394 PMCID: PMC9331275 DOI: 10.3390/jcm11154303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Heart failure (HF) constitutes a significant clinical problem and is associated with a sizeable burden for the healthcare system. Numerous novel techniques, including device interventions, are investigated to improve clinical outcome. A review of the most notable currently studied devices targeting pathophysiological processes in HF was performed. Interventions regarding autonomic nervous system imbalance, i.e., baroreflex activation therapy; vagus, splanchnic and cardiopulmonary nerves modulation; respiratory disturbances, i.e., phrenic nerve stimulation and synchronized diaphragmatic therapy; decongestion management, i.e., the Reprieve system, transcatheter renal venous decongestion system, Doraya, preCardia, WhiteSwell and Aquapass, are presented. Each segment is divided into subsections: potential pathophysiological target, existing evidence and weaknesses or unexplained issues. Novel therapeutic devices represent great potential in HF therapy management; however, further evidence is necessary to fully evaluate their utility.
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