American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death
| Autor: | John S. Floras, Richard O. Russell, Antonio Culebras, Terry Young, Stephen R. Daniels, David P. White, Lyle J. Olson, Fernando Ferreira Costa, Mary Woo, William T. Abraham, Carl E. Hunt, Raouf S. Amin, Virend K. Somers, Thomas G. Pickering |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Central sleep apnea business.industry Vascular disease Sleep apnea Apnea Disease medicine.disease Obesity respiratory tract diseases Obstructive sleep apnea Coronary artery disease Physiology (medical) Internal medicine medicine Cardiology medicine.symptom Cardiology and Cardiovascular Medicine Intensive care medicine business |
| Zdroj: | Circulation. 118:1497-1518 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circulationaha.107.189375 |
| Popis: | Sleep-related breathing disorders are highly prevalent in patients with established cardiovascular disease. Obstructive sleep apnea (OSA) affects an estimated 15 million adult Americans and is present in a large proportion of patients with hypertension and in those with other cardiovascular disorders, including coronary artery disease, stroke, and atrial fibrillation.1–14 In contrast, central sleep apnea (CSA) occurs mainly in patients with heart failure.15–19 The purpose of this Scientific Statement is to describe the types and prevalence of sleep apnea and its relevance to individuals who either are at risk for or already have established cardiovascular disease. Special emphasis is given to recognizing the patient with cardiovascular disease who has coexisting sleep apnea, to understanding the mechanisms by which sleep apnea may contribute to the progression of the cardiovascular condition, and to identifying strategies for treatment. This document is not intended as a systematic review but rather seeks to highlight concepts and evidence important to understanding the interactions between sleep apnea and cardiovascular disease, with particular attention to more recent advances in patient-oriented research. Implicit in this first American Heart Association/American College of Cardiology Scientific Statement on Sleep Apnea and Cardiovascular Disease is the recognition that, although holding great promise, this general area is in need of a substantially expanded knowledge base. Specific questions include whether sleep apnea is important in initiating the development of cardiac and vascular disease, whether sleep apnea in patients with established cardiovascular disease accelerates disease progression, and whether treatment of sleep apnea results in clinical improvement, fewer cardiovascular events, and reduced mortality. Experimental approaches directed at addressing these issues are limited by several considerations. First, the close association between obesity and OSA often obscures differentiation between the effects of obesity, the effects of OSA, and the effects of synergies between these conditions. Second, multiple comorbidities, … |
| Databáze: | OpenAIRE |
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