Sleep-disordered breathing and heart failure: a vicious cycle of cardiovascular risk

Monaldi Arch Chest Dis. 2023 Sep 1;94(2). doi: 10.4081/monaldi.2023.2660.

Abstract

Sleep-disordered breathing (SDB) represents an important cardiovascular risk factor that is still often underestimated and not always optimally treated. Such breathing disorders can induce several harmful effects on the heart, also favoring the development of arrhythmias, ischemic heart disease, and left ventricular remodeling. Obstructive sleep apnea syndrome (OSA) is more frequent in heart failure patients than in the general population, promoting the worsening of left ventricular dysfunction. Both sleep apnea and heart failure have common clinical manifestations but also similar neurohormonal characteristics, contributing to the development and progression of heart failure and resulting in increased mortality. The pathophysiological mechanisms underlying left ventricular dysfunction associated with SDB will be analyzed, and the potential therapeutic effects of gliflozins on OSA in heart failure patients will be discussed.

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology
  • Disease Progression
  • Heart Disease Risk Factors
  • Heart Failure* / complications
  • Heart Failure* / epidemiology
  • Heart Failure* / physiopathology
  • Humans
  • Risk Factors
  • Sleep Apnea Syndromes* / complications
  • Sleep Apnea Syndromes* / epidemiology
  • Sleep Apnea Syndromes* / physiopathology
  • Ventricular Dysfunction, Left* / physiopathology
  • Ventricular Remodeling / physiology