title: Mechanisms and clinical consequences of untreated central sleep apnea in heart failure.
abstract: Central sleep apnea (CSA) is a highly prevalent, though often unrecognized, comorbidity in patients with heart failure (HF). Data from HF population studies suggest that it may present in 30% to 50% of HF patients. CSA is recognized as an important contributor to the progression of HF and to HF-related morbidity and mortality. Over the past 2 decades, an expanding body of research has begun to shed light on the pathophysiologic mechanisms of CSA. Armed with this growing knowledge base, the sleep, respiratory, and cardiovascular research communities have been working to identify ways to treat CSA in HF with the ultimate goal of improving patient quality of life and clinical outcomes. In this paper, we examine the current state of knowledge about the mechanisms of CSA in HF and review emerging therapies for this disorder.
authors.affiliation: Midwest Heart Foundation, Edward Heart Hospital, Naperville, Illinois. Electronic address: mariarosa.costanzo@advocatehealth.com.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Costanzo
authors.affiliation: Division of Pulmonary, Critical Care and Sleep, The Ohio State University, Columbus, Ohio.
authors.forename: Rami
authors.initials: R
authors.lastname: Khayat
authors.affiliation: Cardiac Department, 4th Military Hospital, Wroclaw, Poland; Cardiac Department, Medical University, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
authors.affiliation: Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio.
authors.forename: Ralph
authors.initials: R
authors.lastname: Augostini
authors.affiliation: Department of Cardiology and Intensive Care Medicine, Bielefeld Medical Center, Bielefeld, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Stellbrink
authors.affiliation: Gnarus Medical Consulting, Plymouth, Minnesota.
authors.forename: Marcus
authors.initials: M
authors.lastname: Mianulli
authors.affiliation: Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio.
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
mesh_terms: D001921:Brain / Q000098:blood supply; D002302:Cardiac Output; D015897:Comorbidity; D018450:Disease Progression; D004599:Electric Stimulation Therapy; D004730:Endothelium, Vascular / Q000503:physiopathology; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology; D018384:Oxidative Stress / Q000502:physiology; D010791:Phrenic Nerve / Q000502:physiology; D017286:Polysomnography; D011788:Quality of Life; D012039:Regional Blood Flow; D012307:Risk Factors; D012720:Severity of Illness Index; D020182:Sleep Apnea, Central / Q000453:epidemiology / Q000503:physiopathology*; D013806:Theophylline / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D013806:Theophylline
keywords: apnea-hypopnea index; continuous positive airway pressure; hypoxia; reactive oxygen species; reoxygenation