Sleep Apnea, Heart Failure, and Pulmonary Hypertension
Open accessAbstract
Despite the emergence of sleep apnea (SA) as a significant risk factor for heart failure (HF) mortality, data indicate that SA remains under-diagnosed and under-treated. Less well established, though perhaps more emphasized, is the role of sleep apnea in pulmonary hypertension (PH). SA occurs in approximately 50 % of HF patients, and its consequences include intermittent hypoxemia, arousal, and intra-thoracic pressure swings leading to neurohormonal stimulation, oxidative stress and inflammation. While SA is also considered a cause of PH, severe PH due solely to SA is rare. Combining the results of several studies using Swan-Ganz catheters for diagnosis of PH, approximately 10 % of patients with OSA have PH. Effective treatment of SA in HF is associated with improved survival, while treatment of SA in PH is typically associated with modest hemodynamic improvement.
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The mechanism of pulmonary hypertension in obstructive sleep apnea is not fully understood but is postulated to involve pulmonary arteriolar remodeling, susceptibility to hypoxia, and underlying left heart disease.
“Although the mechanism behind PH associated with OSA is not entirely understood, it is postulated to be due to a combination of factors including pulmonary arteriolar remodeling, susceptibility to hypoxia, and underlying left heart disease.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [773]
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References 46 · Cited by 72
Research works printed but not linked: 1
- [3]Javaheri S Doulgas L Mann F Sleep-related breathing disorders in heart failure A companion to braunwald's heart disease 2010 Philadelphia WB Saunders 471 487 This chapter discusses fundamental pathophysiology of sleep-related breathing disorders.
- Authors
- Javaheri, S., Javaheri, S., & Javaheri, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Javaheri, Sogol
- ORCID
- Javaheri, Sogol
- Venue
- Current Heart Failure Reports
- Published
- 2013-10-06
- Volume
- 10
- Issue
- 4
- Pages
- 315-320
- ISSN
- 1546-9530 (ISSN-L)
- 1546-9549
- PMC
- PMC4111242
- OpenAlex
- W2092072311
- Cited by
- 72
- References
- 46
- Citations by year
- 2026: 2 · 2025: 5 · 2023: 6 · 2022: 9 · 2021: 6 · 2020: 4 · 2019: 6 · 2018: 11 · 2017: 5 · 2016: 7 · 2015: 7 · 2014: 3
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Heart Failure Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007843)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Pharmacology › Apelin-related biomedical research
- Keywords
- sleep apnea, obstructive sleep apnea, heart failure, pulmonary hypertension, intermittent hypoxemia, oxidative stress, inflammation, underdiagnosis, undertreatment, pulmonary artery catheter, hemodynamic improvement, survival
- MeSH terms
- Heart Failure, Humans, Hypertension, Pulmonary, Sleep Apnea Syndromes, Stroke Volume, Prevalence
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