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阻塞性睡眠呼吸暂停与高血压性心脏病:从病理生理学到治疗方法

Obstructive Sleep Apnea and Hypertensive Heart Disease: From Pathophysiology to Therapeutics.

作者信息

Liu Lu, Wang Yi, Hong Liqiong, Bragazzi Nicola Luigi, Dai Haijiang, Chen Huimin

机构信息

Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang, China.

Human Nutrition Unit, Department of Food and Drugs, Medical School, University of Parma, 43125 Parma, Italy.

出版信息

Rev Cardiovasc Med. 2023 Dec 6;24(12):342. doi: 10.31083/j.rcm2412342. eCollection 2023 Dec.

Abstract

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of complete or partial obstruction of the upper airway that lead to intermittent hypoxemia, negative intrathoracic pressure, hypercapnia, and sleep disturbances. While OSA is recognized as a significant risk factor for cardiovascular disease, it's relationship with hypertensive heart disease (HHD) remains underappreciated. HHD is a condition characterized by the pathological hypertrophy of the left ventricle, a consequence of elevated arterial hypertension. Interestingly, both OSA and HHD share similar underlying mechanisms including hypertension, left ventricular hypertrophy, myocardial fibrosis, oxidative stress, and inflammation, which ultimately contribute to the progression of HHD. This review aims to shed light on the potential role of OSA in HHD pathogenesis, summarizing current OSA treatment options. It is hoped that this review will encourage a renewed clinical focus on HHD and underscore the need for further OSA research, particularly in the context of screening and treating HHD patients.

摘要

阻塞性睡眠呼吸暂停(OSA)的特征是上呼吸道反复出现完全或部分阻塞,导致间歇性低氧血症、胸内负压、高碳酸血症和睡眠障碍。虽然OSA被认为是心血管疾病的一个重要危险因素,但其与高血压性心脏病(HHD)的关系仍未得到充分认识。HHD是一种以左心室病理性肥厚为特征的疾病,是动脉高血压升高的结果。有趣的是,OSA和HHD具有相似的潜在机制,包括高血压、左心室肥厚、心肌纤维化、氧化应激和炎症,这些最终都促进了HHD的进展。本综述旨在阐明OSA在HHD发病机制中的潜在作用,总结目前OSA的治疗选择。希望本综述能促使临床重新关注HHD,并强调进一步开展OSA研究的必要性,特别是在筛查和治疗HHD患者方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e1/11272867/6107c6884691/2153-8174-24-12-342-g1.jpg

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