Links Between Obstructive Sleep Apnea and Myocardial Blood Flow Changes Impacting Adverse Cardiovascular Disease-related Outcomes.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2024-07-01 Epub Date: 2024-05-28 DOI:10.1007/s11886-024-02072-z

Ehimen C Aneni, Albert J Sinusas, Morgan C Emokpae, Stephanie L Thorn, H Klar Yaggi, Edward J Miller

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Abstract

Purpose of review: Recent studies have demonstrated an association between obstructive sleep apnea (OSA) and abnormal myocardial blood flow (MBF), myocardial flow reserve (MFR), and coronary microvascular dysfunction (CMD). Here, we review the evidence and describe the potential underlying mechanisms linking OSA to abnormal MBF. Examining relevant studies, we assess the impact of OSA-specific therapy, such as continuous positive airway pressure (CPAP), on MBF.

Recent findings: Recent studies suggest an association between moderate to severe OSA and abnormal MBF/MFR. OSA promotes functional and structural abnormalities of the coronary microcirculation. OSA also promotes the uncoupling of MBF to cardiac work. In a handful of studies with small sample sizes, CPAP therapy improved MBF/MFR. Moderate to severe OSA is associated with abnormal MFR, suggesting an association with CMD. Evidence suggests that CPAP therapy improves MBF. Future studies must determine the clinical impact of improved MBF with CPAP.

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阻塞性睡眠呼吸暂停与影响不良心血管疾病相关结果的心肌血流变化之间的联系

综述目的：最近的研究表明，阻塞性睡眠呼吸暂停（OSA）与心肌血流（MBF）异常、心肌血流储备（MFR）和冠状动脉微血管功能障碍（CMD）之间存在关联。在此，我们回顾了相关证据，并描述了将 OSA 与异常 MBF 联系起来的潜在内在机制。通过对相关研究的考察，我们评估了 OSA 特异性治疗（如持续气道正压（CPAP））对 MBF 的影响：最近的研究表明，中度至重度 OSA 与 MBF/MFR 异常之间存在关联。OSA 会导致冠状动脉微循环功能和结构异常。OSA 还会导致 MBF 与心脏做功脱钩。在少数样本量较小的研究中，CPAP 治疗改善了 MBF/MFR。中度到重度 OSA 与 MFR 异常有关，表明与慢性阻塞性肺疾病有关。有证据表明，CPAP 治疗可改善 MBF。未来的研究必须确定 CPAP 改善 MBF 的临床影响。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.