Sleep apnea and asymptomatic carotid stenosis: a complex interaction.

Abstract:

BACKGROUND:Carotid arteriosclerosis and sleep apnea are considered as independent risk factors for stroke. Whether sleep apnea mediates severity of carotid stenosis remains unclear. Sleep apnea comprises two pathophysiologic conditions: OSA and central sleep apnea (CSA). Although OSA results from upper airway occlusion, CSA reflects enhanced ventilatory drive mainly due to carotid chemoreceptor dysfunction. METHODS:Ninety-six patients with asymptomatic extracranial carotid stenosis of ≥ 50% underwent polysomnography to (1) determine prevalence and severity of sleep apnea for different degrees of carotid stenosis and (2) analyze associations between OSA and CSA, carotid stenosis severity, and other arteriosclerotic risk factors. RESULTS:Sleep apnea was present in 68.8% of patients with carotid stenosis. Prevalence and severity of sleep apnea increased with degree of stenosis (P ≤ .05) because of a rise in CSA (P ≤ .01) but not in OSA. Sleep apnea (OR, 3.8; P ≤ .03) and arterial hypertension (OR, 4.1; P ≤ .05) were associated with stenosis severity, whereas diabetes, smoking, dyslipidemia, BMI, age, and sex were not. Stenosis severity was related to CSA (P ≤ .06) but not to OSA. In addition, CSA but not OSA showed a strong association with arterial hypertension (OR, 12.5; P ≤ .02) and diabetes (OR, 4.5; P ≤ .04). CONCLUSIONS:Sleep apnea is highly prevalent in asymptomatic carotid stenosis. Further, it is associated with arteriosclerotic disease severity as well as presence of hypertension and diabetes. This vascular risk constellation seems to be more strongly connected with CSA than with OSA, possibly attributable to carotid chemoreceptor dysfunction. Because sleep apnea is well treatable, screening should be embedded in stroke prevention strategies.

journal_name

Chest

journal_title

Chest

authors

Ehrhardt J,Schwab M,Finn S,Guenther A,Schultze T,Witte OW,Rupprecht S

doi

10.1378/chest.14-1655

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

1029-1036

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)38952-2

journal_volume

147

pub_type

杂志文章

相关文献

CHEST文献大全
  • Nerve growth factor in serum and lymphocyte culture in pigeon fanciers' acute hypersensitivity pneumonitis.

    abstract:BACKGROUND:Nerve growth factor (NGF) is a neurotrophic cytokine with immunomodulatory activity. NGF contributes to neurogenic inflammation and has been described in asthma and idiopathic pulmonary fibrosis. OBJECTIVES:To identify and quantify NGF in serum and peripheral blood lymphocyte cultures from pigeon fanciers, ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.130.1.37

    authors: McSharry CP,Fraser I,Chaudhuri R,Anderson K,Bourke SJ,Thomson NC,Boyd G

    更新日期:2006-07-01 00:00:00

  • Pleurectomy/decortication and adjuvant therapy for malignant mesothelioma.

    abstract::Malignant mesothelioma is an uncommon and usually fatal cancer, for which there is no standard treatment. However, surgical resection remains the mainstay of treatment because of the inability to treat the entire hemithorax effectively with radiation and the lack of effective chemotherapy drugs. Extrapleural pneumonec...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.4_supplement.382s

    authors: Rusch VW

    更新日期:1993-04-01 00:00:00

  • Increased major bleeding complications related to triple antithrombotic therapy usage in patients with atrial fibrillation undergoing percutaneous coronary artery stenting.

    abstract:BACKGROUND:The optimal antithrombotic therapy strategy for atrial fibrillation (AF) patients who undergo percutaneous coronary intervention with stent implantation (PCI-S) is unknown. We assessed the safety of antithrombotic therapy strategies in AF patients with indication for oral anticoagulation (OAC) undergoing PCI...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.08-0350

    authors: Manzano-Fernández S,Pastor FJ,Marín F,Cambronero F,Caro C,Pascual-Figal DA,Garrido IP,Pinar E,Valdés M,Lip GYH

    更新日期:2008-09-01 00:00:00

  • Clinical Approach to the Therapy of Asthma-COPD Overlap.

    abstract::Over the last few years, there has been a renewed interest in patients with characteristics of both asthma and COPD. Although the precise definition of asthma-COPD overlap (ACO) is still controversial, patients with overlapping features are frequently encountered in clinical practice, and may indeed have worse clinica...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2018.07.028

    authors: Maselli DJ,Hardin M,Christenson SA,Hanania NA,Hersh CP,Adams SG,Anzueto A,Peters JI,Han MK,Martinez FJ

    更新日期:2019-01-01 00:00:00

  • Radiation effect on implanted pacemakers.

    abstract::It was previously thought that diagnostic or therapeutic ionizing radiation did not have an adverse effect on the function of cardiac pacemakers. Recently, however, some authors have reported damaging effect of the therapeutic radiation on cardiac pulse generators. An analysis of a recently-extracted pacemaker documen...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.84.4.499

    authors: Pourhamidi AH

    更新日期:1983-10-01 00:00:00

  • Septic pulmonary embolism: presenting features and clinical course of 14 patients.

    abstract:BACKGROUND:Septic pulmonary embolism (SPE) is an uncommon disorder with an insidious onset and is difficult to diagnose. STUDY OBJECTIVES:To characterize the presenting features and clinical course of patients with SPE. DESIGN:Retrospective study. SETTING:Tertiary care, referral medical center. PATIENTS:Fourteen su...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.1.162

    authors: Cook RJ,Ashton RW,Aughenbaugh GL,Ryu JH

    更新日期:2005-07-01 00:00:00

  • Daytime Cheyne-Stokes respiration in ambulatory patients with severe congestive heart failure is associated with increased mortality.

    abstract:BACKGROUND:Cheyne-Stokes respiration (CSR) frequently occurs in patients with severe heart failure during sleep and may increase mortality. Daytime CSR supposedly poses an even greater risk, but its prevalence and prognostic importance remain elusive. Therefore, we investigated the circadian prevalence of CSR and its i...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0121

    authors: Brack T,Thüer I,Clarenbach CF,Senn O,Noll G,Russi EW,Bloch KE

    更新日期:2007-11-01 00:00:00

  • Metastatic renal cell carcinoma. An unusual cause of syncope.

    abstract::A 77-year-old man with a history of renal cell carcinoma presented with orthostatic syncope. Investigation revealed metastatic carcinoma in the left lung extending through the pulmonary veins into the left atrium obstructing the mitral orifice. On review of the literature, this case appears to be the first to describe...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.2.481

    authors: Fogel RI,Balady GJ,Klein MD,Rajaii-Khorasani A

    更新日期:1990-08-01 00:00:00

  • Diaphragmatic dysfunction in siblings with hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease).

    abstract::Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease) is characterized by chronic degeneration of peripheral nerves and roots, resulting in distal muscle atrophy, beginning in the feet and legs and later involving the hands. The association of this disease with diaphragmatic dysfunction has not been re...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.91.4.567

    authors: Chan CK,Mohsenin V,Loke J,Virgulto J,Sipski ML,Ferranti R

    更新日期:1987-04-01 00:00:00

  • Combined pulmonary fibrosis and emphysema syndrome: a review.

    abstract::There is increasing clinical, radiologic, and pathologic recognition of the coexistence of emphysema and pulmonary fibrosis in the same patient, resulting in a clinical syndrome known as combined pulmonary fibrosis and emphysema (CPFE) that is characterized by dyspnea, upper-lobe emphysema, lower-lobe fibrosis, and ab...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.11-1062

    authors: Jankowich MD,Rounds SIS

    更新日期:2012-01-01 00:00:00

  • Inhaled diuretics attenuate acid-induced cough in children with asthma.

    abstract::To evaluate the effect of inhaled diuretics, furosemide and amiloride, on cough induced by acid inhalation challenge in asthmatic children, a double-blind, randomized, placebo-controlled study was conducted. On separate days, 12 asthmatic children (10.3 +/- 0.7 [SEM] years) underwent acetic acid (AD) inhalation challe...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.107.2.413

    authors: Mochizuki H,Shimizu T,Morikawa A,Kuroume T

    更新日期:1995-02-01 00:00:00

  • The significance of distal bronchial samples with commensals in ventilator-associated pneumonia: colonizer or pathogen?

    abstract:STUDY OBJECTIVE:To investigate the role of oropharyngeal and cutaneous commensal microorganisms (OCCs) as a cause of ventilator-associated pneumonia (VAP). DESIGN:Retrospective analysis of the medical and microbiological records. SETTING:One medical-surgical ICU. PATIENTS:All VAP episodes recorded during a 10-year p...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.122.4.1389

    authors: Lambotte O,Timsit JF,Garrouste-Orgeas M,Misset B,Benali A,Carlet J

    更新日期:2002-10-01 00:00:00

  • The epidemiology of lung cancer.

    abstract::Lung cancer rates and mortality have risen in epidemic proportions in the United States and other industrialized nations during the 20th century. Case-control and cohort studies performed in the 1950s and 1960s firmly established cigarette smoking as the single greatest risk factor for lung cancer. In the United State...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.103.1_supplement.20s

    authors: Samet JM

    更新日期:1993-01-01 00:00:00

  • Propofol-induced pancreatitis: recurrence of pancreatitis after rechallenge.

    abstract::We report a case of pancreatitis, which occurred while the patient was on a propofol drip and then recurred after resolution following an inadvertent rechallenge with propofol. The initial episode was associated with hypertriglyceridemia, whereas the latter was not. The association between propofol and pancreatitis is...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.4.1198

    authors: Kumar AN,Schwartz DE,Lim KG

    更新日期:1999-04-01 00:00:00

  • Sildenafil improves walk distance in idiopathic pulmonary fibrosis.

    abstract::Pulmonary hypertension is a common finding in patients with idiopathic pulmonary fibrosis (IPF), and is associated with increased morbidity and mortality. Therapy with sildenafil has been shown to decrease pulmonary vascular resistance in patients with pulmonary fibrosis and may improve functional status. Patients wit...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.06-2101

    authors: Collard HR,Anstrom KJ,Schwarz MI,Zisman DA

    更新日期:2007-03-01 00:00:00

  • Prolonged reversible quadriparesis in mechanically ventilated patients who received long-term infusions of vecuronium.

    abstract::The use of neuromuscular blocking agents, particularly pancuronium, in patients receiving mechanical ventilation has been reported to cause prolonged paralysis and atrophy. We describe two mechanically ventilated patients with asthma who developed prolonged muscular weakness and atrophy after receiving the shorter-act...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.3.877

    authors: Margolis BD,Khachikian D,Friedman Y,Garrard C

    更新日期:1991-09-01 00:00:00

  • Performance and Interpretation of Invasive Hemodynamic Exercise Testing.

    abstract::Exertional dyspnea is a common complaint for patients seen in pulmonary, cardiac, and general medicine clinics, and elucidating the cause is often challenging, particularly when physical examination, echocardiography, radiography, and pulmonary function test results are inconclusive. Invasive cardiopulmonary exercise ...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2020.05.552

    authors: Jain CC,Borlaug BA

    更新日期:2020-11-01 00:00:00

  • Contrast-enhanced sonography for differential diagnosis of pleurisy and focal pleural lesions of unknown cause.

    abstract:BACKGROUND:Ultrasound enables the visualization of pleural-based lesions with a poor correlation to specific pathology. At this time, there are no data about the diagnostic value of contrast-enhanced sonography (CES) in pleural lesions. METHODS:From August 2004 to January 2005, 25 consecutive patients with clinical sy...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.6.3894

    authors: Görg C,Bert T,Görg K

    更新日期:2005-12-01 00:00:00

  • Diaphragmatic excursion after pleural sclerosis.

    abstract::Chemical sclerosis of the pleural space is used to prevent recurrence of spontaneous pneumothorax. To test whether sclerosis restricts diaphragmatic excursion, we measured diaphragmatic excursion by ultrasonography in subjects with unilateral pleural sclerosis and compared it with diaphragmatic excursions in normal su...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.2.374

    authors: Loring SH,Kurachek SC,Wohl ME

    更新日期:1989-02-01 00:00:00

  • Elevated histamine and tryptase levels in smokers' bronchoalveolar lavage fluid. Do lung mast cells contribute to smokers' emphysema?

    abstract::Human lung mast cells have been reported recently to contain small amounts of the elastolytic protease present in the neutrophil and implicated in the pathogenesis of alveolar wall destruction in emphysema. Since mast cells are numerous within alveolar walls, release of inflammatory mediators (and possibly elastase) b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.1.119

    authors: Kalenderian R,Raju L,Roth W,Schwartz LB,Gruber B,Janoff A

    更新日期:1988-07-01 00:00:00

  • Greater risk of hospitalization in children with Down syndrome and OSA at higher elevation.

    abstract:BACKGROUND:Children with Down syndrome (DS) are at high risk for OSA. Increasing elevation is known to exacerbate underlying respiratory disorders and worsen sleep quality in people without DS, but whether altitude modulates the severity of OSA in DS is uncertain. In this study, we evaluate the impact of elevation (≤ 1...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-1883

    authors: Jensen KM,Sevick CJ,Seewald LAS,Halbower AC,Davis MM,McCabe ERB,Kempe A,Abman SH

    更新日期:2015-05-01 00:00:00

  • Echocardiographic evaluation of pulmonary embolism and its response to therapeutic interventions.

    abstract::Imaging and Doppler echocardiography permits assessment of right ventricular size and systolic function and of pulmonary arterial pressures, and it may facilitate detection of thromboemboli within the heart or pulmonary artery. In patients with acute pulmonary embolism of sufficient severity to appreciably increase ri...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.101.4_supplement.151s

    authors: Come PC

    更新日期:1992-04-01 00:00:00

  • Diagnostic value of medical thoracoscopy in pleural disease: a 6-year retrospective study.

    abstract:STUDY OBJECTIVES:Unlike thoracocentesis and closed pleural biopsy (CPB), medical thoracoscopy permits biopsy with direct visualization. In a 6-year retrospective study of patients having undergone at least one medical thoracoscopy, we analyzed the diagnostic yield of thoracoscopy and its value in the management of pleu...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.121.5.1677

    authors: Blanc FX,Atassi K,Bignon J,Housset B

    更新日期:2002-05-01 00:00:00

  • A combined modality approach to recurrent cardiac sarcoma resulting in a prolonged remission: a case report.

    abstract::We report a case of cardiac fibrosarcoma that was treated with cardiac tumor resection, chemotherapy, cardiac explantation, tumor repeat resection, and autotransplantation followed by external beam irradiation. The patient was able to achieve clinical remission and remained disease free > 2 years after the initial dia...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.123.5.1766

    authors: Mery GM,Reardon MJ,Haas J,Lazar J,Hindenburg A

    更新日期:2003-05-01 00:00:00

  • Efficacy of Acupuncture Is Noninferior to Nicotine Replacement Therapy for Tobacco Cessation: Results of a Prospective, Randomized, Active-Controlled Open-Label Trial.

    abstract:BACKGROUND:We designed and conducted this multicenter randomized active-controlled open-label trial to evaluate the efficacy of acupuncture, auricular point pressing, and nicotine replacement therapy (NRT) on tobacco cessation in the Chinese population. METHODS:This randomized controlled trial was conducted in seven h...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.chest.2017.11.015

    authors: Wang YY,Liu Z,Wu Y,Yang L,Guo LT,Zhang HB,Yang JS,Chinese Acupuncture for Tobacco Cessation Research Team.

    更新日期:2018-03-01 00:00:00

  • Cardiac workload in patients with sleep-disordered breathing early after acute myocardial infarction.

    abstract:BACKGROUND:Sleep-disordered breathing (SDB) may promote an increase in cardiac workload early after acute myocardial infarction (AMI). We tested the hypothesis that in the early phase after AMI, SDB is associated with increased 24-h arterial BP, heart rate (HR), and, thus, cardiac workload. METHODS:In this prospective...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-1930

    authors: Hetzenecker A,Buchner S,Greimel T,Satzl A,Luchner A,Debl K,Husser O,Hamer OW,Fellner C,Riegger GAJ,Pfeifer M,Arzt M

    更新日期:2013-05-01 00:00:00

  • Complications of general anesthesia for Nd:YAG laser resection of endobronchial tumors.

    abstract::We studied the incidence and mechanisms of cardiovascular complications and postoperative respiratory insufficiency associated with GA and Nd:YAG laser endobronchial tumor resection. The records of 73 patients undergoing 87 procedures were reviewed. Preoperative status, anesthetic methods and perioperative complicatio...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.1.72

    authors: Hanowell LH,Martin WR,Savelle JE,Foppiano LE

    更新日期:1991-01-01 00:00:00

  • Oral treprostinil for the treatment of pulmonary arterial hypertension in patients on background endothelin receptor antagonist and/or phosphodiesterase type 5 inhibitor therapy (the FREEDOM-C study): a randomized controlled trial.

    abstract:BACKGROUND:Infused and inhaled treprostinil are effective for treatment of pulmonary arterial hypertension (PAH), although their administration routes have limitations. This study assessed the efficacy and safety of bid oral sustained-release treprostinil in the treatment of PAH with a concomitant endothelin receptor a...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.11-2212

    authors: Tapson VF,Torres F,Kermeen F,Keogh AM,Allen RP,Frantz RP,Badesch DB,Frost AE,Shapiro SM,Laliberte K,Sigman J,Arneson C,Galiè N

    更新日期:2012-12-01 00:00:00

  • Diagnosis and localization of bronchopulmonary air leaks using ventilation scintigraphy.

    abstract:STUDY OBJECTIVES:To determine the usefulness of radioaerosol ventilation scans for the detection and localization of air leaks from the lungs or bronchial tree. DESIGN:Selected patients with suspected air leaks underwent ventilation scans. Retrospective analysis of data was carried out. SETTING AND PATIENTS:Twenty-ei...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.111.2.286

    authors: Mark JB,McDougall IR

    更新日期:1997-02-01 00:00:00

  • Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares.

    abstract:BACKGROUND:Central venous pressure (CVP) is used almost universally to guide fluid therapy in hospitalized patients. Both historical and recent data suggest that this approach may be flawed. OBJECTIVE:A systematic review of the literature to determine the following: (1) the relationship between CVP and blood volume, (...

    journal_title:Chest

    pub_type: 杂志文章,meta分析,评审

    doi:10.1378/chest.07-2331

    authors: Marik PE,Baram M,Vahid B

    更新日期:2008-07-01 00:00:00