1,721,152 research outputs found
Editorial commentary: Sleep disordered breathing and cardiovascular outcomes: is it time to change our thinking?
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Hyperuricemia and non-dipping blood pressure
Get PDFOreste Marrone,1 Maria Rosaria Bonsignore1,21National Research Council, Institute of Biomedicine and Molecular Immunology, Palermo, Italy; 2Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, ItalyThe strong association between the metabolic derangements that characterize the metabolic syndrome with arterial hypertension is very well-known, as it is the common finding of hyperuricemia in the patients with the metabolic syndrome. Besides, hyperuricemia has been found to be associated with cardiovascular, renal, and metabolic diseases; including not only gout but also type 2 diabetes mellitus, although its role as a risk factor is still debated.1 We were not aware of previous studies describing an association between uric acid levels and the non-dipping 24-hour blood pressure (BP) pattern, and for that reason we were intrigued by Tutal et al’s article, regarding hypertensive patients with the metabolic syndrome.2 The authors explain some possible causes that could determine an increase in uric acid in the metabolic syndrome, and describe some pathogenetic mechanisms of systemic hypertension in their patients. We would like to point out one more possible mechanism that could link hyperuricemia to non-dipping BP.View original paper by Tutal et a
Chronic kidney disease in patients with obstructive sleep apnea. A narrative review.
Get PDFPrevalence of both chronic kidney disease (CKD) and obstructive sleep apnea (OSA) is continuously increasing. Moreover, the prevalence of OSA increases as kidney function declines and is higher among patients with end-stage renal disease (ESRD). In addition, OSA is recognized as a potential nontraditional risk factor for development and progression of CKD. Continuous positive airway pressure (CPAP) plays a pivotal role in the management of OSA, eliminating patients' symptoms and improving their quality of life. Recent studies suggested that CPAP treatment may have beneficial effects on kidney function among patients with OSA. This narrative review summarizes the existing knowledge on the association between CKD and OSA, with emphasis on the epidemiology, the pathophysiology of the development of CKD in OSA and vice versa, as well as the effect of CPAP on renal function
Obstructive sleep apnoea in acute coronary syndrome.
Get PDFObstructive sleep apnoea (OSA) syndrome affects about 13% of the male and 7-9% of the female population. Hypoxia, oxidative stress and systemic inflammation link OSA and cardiovascular and metabolic consequences, including coronary artery disease. Current research has identified several clinical phenotypes, and the combination of breathing disturbances during sleep, systemic effects and end-organ damage might help to develop personalised therapeutic approaches. It is unclear whether OSA is a risk factor for acute coronary syndrome (ACS) and might affect its outcome. On the one hand, OSA in patients with ACS may worsen prognosis; on the other hand, OSA-related hypoxaemia could favour the development of coronary collaterals, thereby exerting a protective effect. It is unknown whether positive airway pressure treatment may influence adverse events and consequences of ACS. In non-sleepy patients with OSA and stable coronary artery disease, randomised controlled trials failed to show that continuous positive airway pressure (CPAP) treatment protected against cardiovascular events. Conversely, uncontrolled studies suggested positive effects of CPAP treatment in such patients. Fewer data are available in subjects with ACS and OSA, and results of randomised controlled studies on the effects of CPAP are expected shortly. Meanwhile, the search for reliable markers of risk continues. Recent studies suggest that daytime sleepiness may indicate a more severe OSA phenotype with regard to cardiovascular risk. Finally, some studies suggest sex-related differences. The picture is still incomplete, and the potential role of OSA in patients with ACS awaits confirmation, as well as clear definition of subgroups with different degrees of risk
Supramaximal exercise mobilizes haematopoietic progenitors and reticulocytes in athletes
No full textAm J Physiol Regul Integr Comp Physiol. 2005 Nov;289(5):R1496-503. Epub 2005 Jul 14.
Supramaximal exercise mobilizes hematopoietic progenitors and reticulocytes in athletes.
Morici G, Zangla D, Santoro A, Pelosi E, Petrucci E, Gioia M, Bonanno A, Profita M, Bellia V, Testa U, Bonsignore MR.
SourceDepartment of Experimental Medicine, University of Palermo, Italy.
Abstract
Marathon runners show increased circulating CD34+ cell counts and postexercise release of interleukin-6 (IL-6), granulocyte-colony stimulating factor (G-CSF) and flt3-ligand (Bonsignore MR, Morici G, Santoro A, Pegano M, Cascio L, Bonnano A, Abate P, Mirabella F, Profita M, Insalaco G, Gioia M, Vignola AM, Majolino I, Testa U, and Hogg JC. J Appl Physiol 93: 1691-1697, 2002). In the present study we hypothesized that supramaximal ("all-out") exercise may acutely affect circulating progenitors and reticulocytes and investigated possible mechanisms involved. Progenitor release was measured by flow cytometry (n = 20) and clonogenic assays (n = 6) in 20 young competitive rowers (13 M, 7 F, age +/- SD: 17.1 +/- 2.1 yr, peak O2 consumption: 56.5 +/- 11.4 ml.min(-1).kg(-1)) at rest and shortly after 1,000 m "all-out." Release of reticulocytes, cortisol, muscle enzymes, neutrophil elastase, and several cytokines/growth factors was measured. Supramaximal exercise doubled circulating CD34+ cells (rest: 7.6 +/- 3.0, all-out: 16.3 +/- 9.1 cells/mul, P < 0.001), and increased immature reticulocyte fractions; AC133+ cells doubled, suggesting release of angiogenetic precursors. Erythrocyte burst forming units and colony forming units for granulocytes-monocytes and all blood series increased postexercise by 3.4-, 5.5-, and 4.8-fold, respectively (P < 0.01 for all). All-out rowing acutely increased plasma cortisol, neutrophil elastase, flt3-ligand, hepatocyte growth factor, VEGF, and transforming growth factor-beta1, and decreased erythropoietin; K-ligand, stromal-derived factor-1, IL-6, and G-CSF were unchanged. Therefore, all-out exercise is a physiological stimulus for progenitor release in athletes. Release of reticulocytes and proangiogenetic cells and mediators suggests tissue hypoxia as possibly involved in progenitor mobilization.
PMID:16020520[PubMed - indexed for MEDLINE
Cardiovascular Events in Moderately to Severely Obese Obstructive Sleep Apnea Patients on Positive Airway Pressure Therapy
No full textBackground: In moderately to severely obese patients with
obstructive sleep apnea (OSA), the effects of long-term positive
airway pressure (PAP) treatment on cardiovascular risk
are poorly defined. Purpose: To assess the effect of continuous
positive airway pressure (CPAP) or noninvasive ventilation
(NIV) on the occurrence of cardiovascular events in
obese OSA patients. Methods: We performed a noninterventional
observational study in obese OSA patients recruited
between 2007 and 2010 at the Sleep Center, University of
Grenoble, treated with CPAP or NIV, and followed for 5.6
years by a single home care provider. Baseline clinical characteristics,
blood chemistry, and respiratory and vascular
function were assessed. Incident cardiovascular events were
investigated by phone interviews. Results: A total of 103 patients
(55 men, 48 women; age and body mass index [BMI] at
diagnosis 54.1 ± 10.5 years and 40.3 ± 5.5, respectively [mean
± standard deviation]; CPAP: n = 75; NIV: n = 28) agreed to
participate in the study. Grade I, II, and III obesity occurred in 17.5, 33.0, and 49.5% of the sample, respectively. In patients
using PAP treatment ( n = 69), the mean nightly use was
6.3 ± 2.4 h. Thirty-one patients stopped PAP treatment during
follow-up. Three patients on NIV died. Nonfatal cardiovascular
events ( n = 27) occurred in 19 patients, who were
older and showed higher number of comorbidities and triglyceride
levels than patients without events. In the patients
who interrupted treatment, the event rate was high and increased
with the number of comorbidities, while BMI at
baseline did not predict events. Conclusions: The study suggests
that regular PAP treatment may be associated with
protection against cardiovascular risk in obese OSA patients,
especially in the presence of multiple comorbidities
A new index for the quantitative evaluation of the cardiovascular effects of obstructive sleep apnea syndrome
No full textAirway neutrophilic inflammation decreases after exercise-based rehabilitation in COPD patients
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