Changes in Left Heart Geometry, Function, and Blood Serum Biomarkers in Patients with Obstructive Sleep Apnea after Treatment with Continuous Positive Airway Pressure
Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfun...
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| Published in: | Medicina (Kaunas, Lithuania) Vol. 58; no. 11; p. 1511 |
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| Format: | Journal Article |
| Language: | English |
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24.10.2022
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| ISSN: | 1648-9144, 1010-660X, 1648-9144 |
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| Abstract | Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfunction diagnosis and thus might help as an earlier treatment for OSA patients. It is still not clear which blood serum biomarkers could be used to assess CPAP treatment efficacy. Objectives: To evaluate left heart geometry, function, deformation parameters, and blood serum biomarker (galectin-3, sST2, endothelin-1) levels in patients with OSA, as well as to assess changes after short-term CPAP treatment. Materials and Methods: Thirty-four patients diagnosed with moderate or severe OSA, as well as thirteen patients as a control group, were included in the study. All the subjects were obese (body mass index (BMI) > 30 kg/m2). Transthoracic 2D ST echocardiography was performed before and after 3 months of treatment with CPAP; for the control group, at baseline only. Peripheral blood samples for the testing of biomarkers were collected at the time of study enrolment before the initiation of CPAP therapy and after 3 months of CPAP treatment (blood samples were taken just for OSA group patients). Results: The left ventricle (LV) end-diastolic diameter and volume, as well as LV ejection fraction (EF), did not differ between groups, but an increased LV end-systolic volume and a reduced LV global longitudinal strain (GLS) were found in the OSA group patients (p = 0.015 and p = 0.035, respectively). Indexed by height, higher LV MMi in OSA patients (p = 0.007) and a higher prevalence of LV diastolic dysfunction (p = 0.023) were found in this group of patients. Although left atrium (LA) volume did not differ between groups, OSA group patients had significantly lower LA reservoir strain (p < 0.001). Conventional RV longitudinal and global function parameters (S′, fractional area change (FAC)) did not differ between groups; however, RV GLS was reduced in OSA patients (p = 0.026). OSA patients had a significantly higher right atrium (RA) diameter and mean pulmonary artery pressure (PAP) (p < 0.05). Galectin-3 and sST2 concentrations significantly decreased after 3 months of CPAP treatment. Conclusions: OSA is associated with the left heart remodeling process—increased LV myocardial mass index, LV diastolic dysfunction, reduced LV and RV longitudinal strain, and reduced LA reservoir function. A short-term, 3-months CPAP treatment improves LV global longitudinal strain and LA reservoir function and positively affects blood serum biomarkers. This new indexing system for LV myocardial mass by height helps to identify myocardial structural changes in obese patients with OSA. |
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| AbstractList | Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfunction diagnosis and thus might help as an earlier treatment for OSA patients. It is still not clear which blood serum biomarkers could be used to assess CPAP treatment efficacy. Objectives: To evaluate left heart geometry, function, deformation parameters, and blood serum biomarker (galectin-3, sST2, endothelin-1) levels in patients with OSA, as well as to assess changes after short-term CPAP treatment. Materials and Methods: Thirty-four patients diagnosed with moderate or severe OSA, as well as thirteen patients as a control group, were included in the study. All the subjects were obese (body mass index (BMI) > 30 kg/m2). Transthoracic 2D ST echocardiography was performed before and after 3 months of treatment with CPAP; for the control group, at baseline only. Peripheral blood samples for the testing of biomarkers were collected at the time of study enrolment before the initiation of CPAP therapy and after 3 months of CPAP treatment (blood samples were taken just for OSA group patients). Results: The left ventricle (LV) end-diastolic diameter and volume, as well as LV ejection fraction (EF), did not differ between groups, but an increased LV end-systolic volume and a reduced LV global longitudinal strain (GLS) were found in the OSA group patients (p = 0.015 and p = 0.035, respectively). Indexed by height, higher LV MMi in OSA patients (p = 0.007) and a higher prevalence of LV diastolic dysfunction (p = 0.023) were found in this group of patients. Although left atrium (LA) volume did not differ between groups, OSA group patients had significantly lower LA reservoir strain (p < 0.001). Conventional RV longitudinal and global function parameters (S′, fractional area change (FAC)) did not differ between groups; however, RV GLS was reduced in OSA patients (p = 0.026). OSA patients had a significantly higher right atrium (RA) diameter and mean pulmonary artery pressure (PAP) (p < 0.05). Galectin-3 and sST2 concentrations significantly decreased after 3 months of CPAP treatment. Conclusions: OSA is associated with the left heart remodeling process—increased LV myocardial mass index, LV diastolic dysfunction, reduced LV and RV longitudinal strain, and reduced LA reservoir function. A short-term, 3-months CPAP treatment improves LV global longitudinal strain and LA reservoir function and positively affects blood serum biomarkers. This new indexing system for LV myocardial mass by height helps to identify myocardial structural changes in obese patients with OSA. Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfunction diagnosis and thus might help as an earlier treatment for OSA patients. It is still not clear which blood serum biomarkers could be used to assess CPAP treatment efficacy. Objectives: To evaluate left heart geometry, function, deformation parameters, and blood serum biomarker (galectin-3, sST2, endothelin-1) levels in patients with OSA, as well as to assess changes after short-term CPAP treatment. Materials and Methods: Thirty-four patients diagnosed with moderate or severe OSA, as well as thirteen patients as a control group, were included in the study. All the subjects were obese (body mass index (BMI) > 30 kg/m2). Transthoracic 2D ST echocardiography was performed before and after 3 months of treatment with CPAP; for the control group, at baseline only. Peripheral blood samples for the testing of biomarkers were collected at the time of study enrolment before the initiation of CPAP therapy and after 3 months of CPAP treatment (blood samples were taken just for OSA group patients). Results: The left ventricle (LV) end-diastolic diameter and volume, as well as LV ejection fraction (EF), did not differ between groups, but an increased LV end-systolic volume and a reduced LV global longitudinal strain (GLS) were found in the OSA group patients (p = 0.015 and p = 0.035, respectively). Indexed by height, higher LV MMi in OSA patients (p = 0.007) and a higher prevalence of LV diastolic dysfunction (p = 0.023) were found in this group of patients. Although left atrium (LA) volume did not differ between groups, OSA group patients had significantly lower LA reservoir strain (p < 0.001). Conventional RV longitudinal and global function parameters (S′, fractional area change (FAC)) did not differ between groups; however, RV GLS was reduced in OSA patients (p = 0.026). OSA patients had a significantly higher right atrium (RA) diameter and mean pulmonary artery pressure (PAP) (p < 0.05). Galectin-3 and sST2 concentrations significantly decreased after 3 months of CPAP treatment. Conclusions: OSA is associated with the left heart remodeling process—increased LV myocardial mass index, LV diastolic dysfunction, reduced LV and RV longitudinal strain, and reduced LA reservoir function. A short-term, 3-months CPAP treatment improves LV global longitudinal strain and LA reservoir function and positively affects blood serum biomarkers. This new indexing system for LV myocardial mass by height helps to identify myocardial structural changes in obese patients with OSA.Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfunction diagnosis and thus might help as an earlier treatment for OSA patients. It is still not clear which blood serum biomarkers could be used to assess CPAP treatment efficacy. Objectives: To evaluate left heart geometry, function, deformation parameters, and blood serum biomarker (galectin-3, sST2, endothelin-1) levels in patients with OSA, as well as to assess changes after short-term CPAP treatment. Materials and Methods: Thirty-four patients diagnosed with moderate or severe OSA, as well as thirteen patients as a control group, were included in the study. All the subjects were obese (body mass index (BMI) > 30 kg/m2). Transthoracic 2D ST echocardiography was performed before and after 3 months of treatment with CPAP; for the control group, at baseline only. Peripheral blood samples for the testing of biomarkers were collected at the time of study enrolment before the initiation of CPAP therapy and after 3 months of CPAP treatment (blood samples were taken just for OSA group patients). Results: The left ventricle (LV) end-diastolic diameter and volume, as well as LV ejection fraction (EF), did not differ between groups, but an increased LV end-systolic volume and a reduced LV global longitudinal strain (GLS) were found in the OSA group patients (p = 0.015 and p = 0.035, respectively). Indexed by height, higher LV MMi in OSA patients (p = 0.007) and a higher prevalence of LV diastolic dysfunction (p = 0.023) were found in this group of patients. Although left atrium (LA) volume did not differ between groups, OSA group patients had significantly lower LA reservoir strain (p < 0.001). Conventional RV longitudinal and global function parameters (S′, fractional area change (FAC)) did not differ between groups; however, RV GLS was reduced in OSA patients (p = 0.026). OSA patients had a significantly higher right atrium (RA) diameter and mean pulmonary artery pressure (PAP) (p < 0.05). Galectin-3 and sST2 concentrations significantly decreased after 3 months of CPAP treatment. Conclusions: OSA is associated with the left heart remodeling process—increased LV myocardial mass index, LV diastolic dysfunction, reduced LV and RV longitudinal strain, and reduced LA reservoir function. A short-term, 3-months CPAP treatment improves LV global longitudinal strain and LA reservoir function and positively affects blood serum biomarkers. This new indexing system for LV myocardial mass by height helps to identify myocardial structural changes in obese patients with OSA. Background: Cardiovascular remodeling is essential in patients with obstructive sleep apnea (OSA), and continuous positive airway pressure (CPAP) therapy could improve these processes. Two-dimensional (2D) speckle-tracking (ST) echocardiography is a useful method for subclinical biventricular dysfunction diagnosis and thus might help as an earlier treatment for OSA patients. It is still not clear which blood serum biomarkers could be used to assess CPAP treatment efficacy. Objectives: To evaluate left heart geometry, function, deformation parameters, and blood serum biomarker (galectin-3, sST2, endothelin-1) levels in patients with OSA, as well as to assess changes after short-term CPAP treatment. Materials and Methods: Thirty-four patients diagnosed with moderate or severe OSA, as well as thirteen patients as a control group, were included in the study. All the subjects were obese (body mass index (BMI) > 30 kg/m[sup.2] ). Transthoracic 2D ST echocardiography was performed before and after 3 months of treatment with CPAP; for the control group, at baseline only. Peripheral blood samples for the testing of biomarkers were collected at the time of study enrolment before the initiation of CPAP therapy and after 3 months of CPAP treatment (blood samples were taken just for OSA group patients). Results: The left ventricle (LV) end-diastolic diameter and volume, as well as LV ejection fraction (EF), did not differ between groups, but an increased LV end-systolic volume and a reduced LV global longitudinal strain (GLS) were found in the OSA group patients (p = 0.015 and p = 0.035, respectively). Indexed by height, higher LV MMi in OSA patients (p = 0.007) and a higher prevalence of LV diastolic dysfunction (p = 0.023) were found in this group of patients. Although left atrium (LA) volume did not differ between groups, OSA group patients had significantly lower LA reservoir strain (p < 0.001). Conventional RV longitudinal and global function parameters (S′, fractional area change (FAC)) did not differ between groups; however, RV GLS was reduced in OSA patients (p = 0.026). OSA patients had a significantly higher right atrium (RA) diameter and mean pulmonary artery pressure (PAP) (p < 0.05). Galectin-3 and sST2 concentrations significantly decreased after 3 months of CPAP treatment. Conclusions: OSA is associated with the left heart remodeling process—increased LV myocardial mass index, LV diastolic dysfunction, reduced LV and RV longitudinal strain, and reduced LA reservoir function. A short-term, 3-months CPAP treatment improves LV global longitudinal strain and LA reservoir function and positively affects blood serum biomarkers. This new indexing system for LV myocardial mass by height helps to identify myocardial structural changes in obese patients with OSA. |
| Audience | Academic |
| Author | Kondratavičienė, Laima Malakauskas, Kęstutis Vasylė, Eglė Januškevičius, Andrius Ereminienė, Eglė Tamulėnaitė, Eglė Žemaitis, Marius Miliauskas, Skaidrius |
| AuthorAffiliation | 3 Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania 2 Department of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania 1 Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania |
| AuthorAffiliation_xml | – name: 3 Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania – name: 1 Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania – name: 2 Department of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania |
| Author_xml | – sequence: 1 givenname: Laima orcidid: 0000-0001-6384-9392 surname: Kondratavičienė fullname: Kondratavičienė, Laima – sequence: 2 givenname: Eglė surname: Tamulėnaitė fullname: Tamulėnaitė, Eglė – sequence: 3 givenname: Eglė surname: Vasylė fullname: Vasylė, Eglė – sequence: 4 givenname: Andrius surname: Januškevičius fullname: Januškevičius, Andrius – sequence: 5 givenname: Eglė surname: Ereminienė fullname: Ereminienė, Eglė – sequence: 6 givenname: Kęstutis surname: Malakauskas fullname: Malakauskas, Kęstutis – sequence: 7 givenname: Marius surname: Žemaitis fullname: Žemaitis, Marius – sequence: 8 givenname: Skaidrius orcidid: 0009-0002-6130-0712 surname: Miliauskas fullname: Miliauskas, Skaidrius |
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| Cites_doi | 10.1161/CIRCULATIONAHA.104.501841 10.3390/medicina58030350 10.1155/2014/930535 10.1164/rccm.201908-1593LE 10.5603/KP.a2016.0185 10.1161/JAHA.119.014609 10.1371/journal.pone.0062298 10.1155/2020/2587530 10.1177/1753466619880076 10.1378/chest.11-0615 10.1016/j.ijcha.2016.05.011 10.3343/alm.2018.38.4.306 10.1007/s00059-019-04850-w 10.1097/01.hjh.0000570772.89851.13 10.1016/j.echo.2014.10.003 10.1016/j.sleep.2021.03.039 10.21037/apm-20-1125 10.1016/j.ahj.2010.06.033 10.1378/chest.11-2322 10.1016/j.chest.2021.12.669 10.1016/j.acvd.2016.02.011 10.1016/j.exer.2010.11.009 10.1007/s00405-018-5225-8 10.3390/biom11081167 10.1111/jch.14488 10.1007/s11325-021-02382-4 10.1001/jamacardio.2016.0962 10.1016/j.echo.2016.01.011 10.1016/j.echo.2019.03.020 10.1093/ejechocard/jep215 10.1016/j.hfc.2019.08.009 10.1056/NEJMoa043104 10.1378/chest.12-2114 10.1183/16000617.0077-2015 10.1111/echo.13225 10.1080/AC.69.2.3017299 10.5551/jat.RV17009 10.1016/j.immuni.2005.09.015 10.1164/rccm.2109080 10.1056/NEJMoa1606599 10.1007/s11325-015-1260-5 10.1016/j.cca.2016.06.046 10.1161/01.CIR.0000061757.12581.15 10.1093/eurjcn/zvab060.126 10.1093/ehjci/jey042 10.1016/j.ccm.2006.12.001 10.1136/jcp.48.6.519 10.1016/j.sleep.2007.06.018 10.1007/s11325-019-01788-5 10.1038/s41598-019-49511-4 10.1155/2017/1587865 |
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| Keywords | obstructive sleep apnea two-dimensional speckle-tracking echocardiography sST2 endothelin-1 continuous positive airway pressure galectin-3 |
| Language | English |
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| References | Zota (ref_45) 2018; 2018 Maripov (ref_10) 2017; 2017 Cicco (ref_36) 2021; 82 Chetan (ref_58) 2021; 23 Montesi (ref_13) 2012; 142 Andrejic (ref_34) 2019; 9 Coniglio (ref_2) 2020; 1 ref_17 Singh (ref_18) 2019; 23 Maeder (ref_15) 2016; 460 Abe (ref_4) 2017; 24 Nagueh (ref_28) 2016; 29 Dong (ref_31) 2018; 41 Ferri (ref_39) 1995; 48 Bodez (ref_44) 2016; 109 Yaggi (ref_3) 2005; 353 Jun (ref_1) 2016; 139 ref_25 ref_21 Vural (ref_57) 2014; 69 Ventura (ref_40) 2016; 20 Colish (ref_47) 2012; 141 Andreieva (ref_32) 2018; 52 Bradley (ref_7) 2003; 107 ref_27 Lin (ref_24) 2019; 276 Arias (ref_9) 2005; 112 Egea (ref_42) 2008; 9 Ikejder (ref_43) 2020; 2020 Furlan (ref_46) 2022; 161 (ref_23) 2022; 26 Anton (ref_38) 2017; 2017 ref_35 Haruki (ref_53) 2010; 11 Schmitz (ref_20) 2005; 23 Tadic (ref_51) 2022; 24 Yu (ref_6) 2020; 45 Wan (ref_55) 2021; 10 Young (ref_5) 2002; 165 Papanikolaou (ref_8) 2019; 13 Daniels (ref_37) 2010; 160 Lang (ref_26) 2015; 28 Panjwani (ref_16) 2011; 92 Javaheri (ref_49) 2019; 201 McEvoy (ref_50) 2016; 375 Jankowich (ref_41) 2016; 1 Pusuroglu (ref_19) 2017; 75 Martone (ref_52) 2016; 33 Archontogeorgis (ref_14) 2014; 2014 Parasuraman (ref_30) 2016; 12 Kim (ref_54) 2019; 32 ref_48 Badano (ref_29) 2018; 19 Oudiz (ref_12) 2007; 28 Andreieva (ref_22) 2020; 56 Hansdottir (ref_11) 2013; 144 Ansari (ref_33) 2018; 38 Sacks (ref_56) 2018; 13 |
| References_xml | – volume: 112 start-page: 375 year: 2005 ident: ref_9 article-title: Obstructive sleep apnea syndrome affects left ventricular diastolic function: Effects of nasal continuous positive airway pressure in men publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.104.501841 – ident: ref_25 doi: 10.3390/medicina58030350 – volume: 2014 start-page: 930535 year: 2014 ident: ref_14 article-title: Biomarkers to Improve Diagnosis and Monitoring of Obstructive Sleep Apnea Syndrome: Current Status and Future Perspectives publication-title: Pulm. Med. doi: 10.1155/2014/930535 – volume: 201 start-page: 607 year: 2019 ident: ref_49 article-title: CPAP Adherence for prevention of major adverse cerebrovascular and cardiovascular events in obstructive sleep apnea publication-title: Am. J. Respir. Crit. Care Med. doi: 10.1164/rccm.201908-1593LE – volume: 75 start-page: 351 year: 2017 ident: ref_19 article-title: Galectin-3 is associated with coronary plaque burden and obstructive sleep apnoea syndrome severity publication-title: Kardiol. Pol. doi: 10.5603/KP.a2016.0185 – ident: ref_27 doi: 10.1161/JAHA.119.014609 – ident: ref_48 doi: 10.1371/journal.pone.0062298 – volume: 2020 start-page: 2587530 year: 2020 ident: ref_43 article-title: Impact of Arterial Hypertension on Left Atrial Size and Function publication-title: Biomed Res. Int. doi: 10.1155/2020/2587530 – volume: 13 start-page: 1753466619880076 year: 2019 ident: ref_8 article-title: Diastolic dysfunction in men with severe obstructive sleep apnea syndrome but without cardiovascular or oxidative stress-related comorbidities publication-title: Ther. Adv. Respir. Dis. doi: 10.1177/1753466619880076 – volume: 141 start-page: 674 year: 2012 ident: ref_47 article-title: Obstructive sleep apnea: Effects of continuous positive airway pressure on cardiac remodeling as assessed by cardiac biomarkers, echocardiography, and cardiac MRI publication-title: Chest doi: 10.1378/chest.11-0615 – volume: 12 start-page: 45 year: 2016 ident: ref_30 article-title: Assessment of pulmonary artery pressure by echocardiography—A comprehensive review publication-title: IJC Heart Vasc. doi: 10.1016/j.ijcha.2016.05.011 – volume: 38 start-page: 306 year: 2018 ident: ref_33 article-title: Galectin-3 Reflects the Echocardiographic Grades of Left Ventricular Diastolic Dysfunction publication-title: Ann. Lab. Med. doi: 10.3343/alm.2018.38.4.306 – volume: 45 start-page: 726 year: 2020 ident: ref_6 article-title: Left ventricular remodeling and dysfunction in obstructive sleep apnea: Systematic review and meta-analysis publication-title: Herz doi: 10.1007/s00059-019-04850-w – ident: ref_35 doi: 10.1097/01.hjh.0000570772.89851.13 – volume: 13 start-page: 612 year: 2018 ident: ref_56 article-title: Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke publication-title: Int. J. Stroke – volume: 28 start-page: 1 year: 2015 ident: ref_26 article-title: Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging publication-title: J. Am. Soc. Echocardiogr. doi: 10.1016/j.echo.2014.10.003 – volume: 82 start-page: 117 year: 2021 ident: ref_36 article-title: Galectin-3 and neutrophil-to-lymphocyte ratio are indicative of heart remodelling and disease severity in patients with obstructive sleep apnoea publication-title: Sleep Med. doi: 10.1016/j.sleep.2021.03.039 – volume: 23 start-page: 213 year: 2021 ident: ref_58 article-title: Understanding the role of echocardiography in patients with obstructive sleep apnea and right ventricular subclinical myocardial dysfunction Comparison with other conditions affecting RV deformation publication-title: Med. Ultrason. – volume: 2017 start-page: 2714095 year: 2017 ident: ref_38 article-title: Serum Soluble ST2 and Diastolic Dysfunction in Hypertensive Patients publication-title: Dis. Markers – volume: 10 start-page: 2668 year: 2021 ident: ref_55 article-title: Left atrial dysfunction in patients with obstructive sleep apnea: A combined assessment by speckle tracking and real-time three-dimensional echocardiography publication-title: Ann. Palliat. Med. doi: 10.21037/apm-20-1125 – volume: 41 start-page: 599 year: 2018 ident: ref_31 article-title: Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review) publication-title: Int. J. Mol. Med. – volume: 2018 start-page: 1206217 year: 2018 ident: ref_45 article-title: Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea publication-title: Can. Respir. J. – volume: 160 start-page: 721 year: 2010 ident: ref_37 article-title: Association of ST2 levels with cardiac structure and function and mortality in outpatients publication-title: Am. Heart J. doi: 10.1016/j.ahj.2010.06.033 – volume: 142 start-page: 239 year: 2012 ident: ref_13 article-title: Biomarkers of sleep apnea publication-title: Chest doi: 10.1378/chest.11-2322 – volume: 161 start-page: 1370 year: 2022 ident: ref_46 article-title: Effects of CPAP on Metabolic Syndrome in Patients With OSA: A Randomized Trial publication-title: Chest doi: 10.1016/j.chest.2021.12.669 – volume: 109 start-page: 494 year: 2016 ident: ref_44 article-title: Consequences of obstructive sleep apnoea syndrome on left ventricular geometry and diastolic function publication-title: Arch. Cardiovasc. Dis. doi: 10.1016/j.acvd.2016.02.011 – volume: 92 start-page: 2 year: 2011 ident: ref_16 article-title: Focus on molecules: Galectin-3 publication-title: Exp. Eye Res. doi: 10.1016/j.exer.2010.11.009 – volume: 276 start-page: 623 year: 2019 ident: ref_24 article-title: Effect of continuous positive airway pressure on endothelin-1 in patients with obstructive sleep apnea: A meta-analysis publication-title: Eur. Arch. Otorhinolaryngol. doi: 10.1007/s00405-018-5225-8 – ident: ref_17 doi: 10.3390/biom11081167 – volume: 24 start-page: 795 year: 2022 ident: ref_51 article-title: The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta-analysis of echocardiographic studies publication-title: J. Clin. Hypertens. doi: 10.1111/jch.14488 – volume: 26 start-page: 231 year: 2022 ident: ref_23 article-title: Endothelial dysfunction in obstructive sleep apnea patients publication-title: Sleep Breath. doi: 10.1007/s11325-021-02382-4 – volume: 56 start-page: 4738 year: 2020 ident: ref_22 article-title: Effects of CPAP and mandibular advancement devices on cardiac biomarkers in patients with obstructive sleep apnea publication-title: Eur. Respir. J. – volume: 1 start-page: 461 year: 2016 ident: ref_41 article-title: Association of Elevated Plasma Endothelin-1 Levels With Pulmonary Hypertension, Mortality, and Heart Failure in African American Individuals: The Jackson Heart Study publication-title: JAMA Cardiol. doi: 10.1001/jamacardio.2016.0962 – volume: 29 start-page: 277 year: 2016 ident: ref_28 article-title: Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging publication-title: J. Am. Soc. Echocardiogr. doi: 10.1016/j.echo.2016.01.011 – volume: 32 start-page: 826 year: 2019 ident: ref_54 article-title: Continuous Positive Airway Pressure Therapy Restores Cardiac Mechanical Function in Patients with Severe Obstructive Sleep Apnea: A Randomized, Sham-Controlled Study publication-title: J. Am. Soc. Echocardiogr. doi: 10.1016/j.echo.2019.03.020 – volume: 11 start-page: 352 year: 2010 ident: ref_53 article-title: Continuous positive airway pressure ameliorates sleep-induced subclinical left ventricular systolic dysfunction: Demonstration by two-dimensional speckle-tracking echocardiography publication-title: Eur. J. Echocardiogr. doi: 10.1093/ejechocard/jep215 – volume: 1 start-page: 45 year: 2020 ident: ref_2 article-title: Sleep Breathing Disorders in Heart Failure publication-title: Heart Fail Clin. doi: 10.1016/j.hfc.2019.08.009 – volume: 353 start-page: 2034 year: 2005 ident: ref_3 article-title: Obstructive sleep apnea as a risk factor for stroke and death publication-title: N. Engl. J. Med. doi: 10.1056/NEJMoa043104 – volume: 144 start-page: 638 year: 2013 ident: ref_11 article-title: WHO’s in second?: A practical review of World Health Organization group 2 pulmonary hypertension publication-title: Chest doi: 10.1378/chest.12-2114 – volume: 139 start-page: 12 year: 2016 ident: ref_1 article-title: Sleep apnoea publication-title: Eur. Respir. Rev. doi: 10.1183/16000617.0077-2015 – volume: 33 start-page: 1144 year: 2016 ident: ref_52 article-title: Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study publication-title: Echocardiography doi: 10.1111/echo.13225 – volume: 69 start-page: 175 year: 2014 ident: ref_57 article-title: Impact of continuous positive airway pressure therapy on left atrial function in patients with obstructive sleep apnoea: Assessment by conventional and two-dimensional speckle-tracking echocardiography publication-title: Acta Cardiol. doi: 10.1080/AC.69.2.3017299 – volume: 52 start-page: PA4332 year: 2018 ident: ref_32 article-title: The effect of CPAP treatment on Galectin-3 level in patients with severe obstructive sleep apnea publication-title: Eur. Respir. J. – volume: 24 start-page: 884 year: 2017 ident: ref_4 article-title: The Roles of Hypoxia Signaling in the Pathogenesis of Cardiovascular Diseases publication-title: J. Atheroscler. Thromb. doi: 10.5551/jat.RV17009 – volume: 23 start-page: 479 year: 2005 ident: ref_20 article-title: IL-33, an interleukin-1-like cytokine that signals via the IL-1 receptor-related protein ST2 and induces T helper type 2-associated cytokines publication-title: Immunity doi: 10.1016/j.immuni.2005.09.015 – volume: 165 start-page: 1217 year: 2002 ident: ref_5 article-title: Epidemiology of obstructive sleep apnea: A population health perspective publication-title: Am. J. Respir. Crit. Care Med. doi: 10.1164/rccm.2109080 – volume: 375 start-page: 919 year: 2016 ident: ref_50 article-title: CPAP for prevention of cardiovascular events in obstructive sleep apnea publication-title: N. Engl. J. Med. doi: 10.1056/NEJMoa1606599 – volume: 20 start-page: 613 year: 2016 ident: ref_40 article-title: Echocardiographic findings and plasma endothelin-1 levels in obese patients with and without obstructive sleep apnea publication-title: Sleep Breath. doi: 10.1007/s11325-015-1260-5 – volume: 460 start-page: 152 year: 2016 ident: ref_15 article-title: Biomarkers of cardiovascular stress in obstructive sleep apnea publication-title: Clin. Chim. Acta. doi: 10.1016/j.cca.2016.06.046 – volume: 107 start-page: 1671 year: 2003 ident: ref_7 article-title: Sleep apnea and heart failure: Part I: Obstructive sleep apnea publication-title: Circulation doi: 10.1161/01.CIR.0000061757.12581.15 – ident: ref_21 doi: 10.1093/eurjcn/zvab060.126 – volume: 19 start-page: 591 year: 2018 ident: ref_29 article-title: Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: A consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging publication-title: Eur. Heart J. Cardiovasc. Imaging doi: 10.1093/ehjci/jey042 – volume: 28 start-page: 233 year: 2007 ident: ref_12 article-title: Pulmonary hypertension associated with left-sided heart disease publication-title: Clin. Chest Med. doi: 10.1016/j.ccm.2006.12.001 – volume: 48 start-page: 519 year: 1995 ident: ref_39 article-title: Circulating endothelin-1 concentrations in patients with chronic hypoxia publication-title: J. Clin. Pathol. doi: 10.1136/jcp.48.6.519 – volume: 9 start-page: 660 year: 2008 ident: ref_42 article-title: Cardiac function after CPAP therapy in patients with chronic heart failure and sleep apnea: A multicenter study publication-title: Sleep Med. doi: 10.1016/j.sleep.2007.06.018 – volume: 23 start-page: 1107 year: 2019 ident: ref_18 article-title: Sleep apnea and galectin-3: Possible sex-specific relationship publication-title: Sleep Breath. doi: 10.1007/s11325-019-01788-5 – volume: 9 start-page: 13145 year: 2019 ident: ref_34 article-title: Association between Galectin-3 levels within central and peripheral venous blood, and adverse left ventricular remodelling after first acute myocardial infarction publication-title: Sci. Rep. doi: 10.1038/s41598-019-49511-4 – volume: 2017 start-page: 1587865 year: 2017 ident: ref_10 article-title: Right ventricular remodeling and dysfunction in obstructive sleep apnea: A systematic review of the literature and meta-analysis publication-title: Can. Respir. J. doi: 10.1155/2017/1587865 |
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| SubjectTerms | Airway management Analysis Biological markers Biomarkers Blood pressure Cardiovascular disease Cardiovascular system Care and treatment Clinical trials Continuous positive airway pressure Continuous Positive Airway Pressure - methods Diagnosis endothelin-1 Galectin 3 Heart Humans Hypoxia Measurement Methods Mortality Obesity - complications obstructive sleep apnea Patient compliance Patient outcomes Polysomnography Pulmonary arteries Pulmonary hypertension Serum Sleep apnea Sleep apnea syndromes Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - therapy sST2 two-dimensional speckle-tracking echocardiography Ventricular Dysfunction, Left |
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