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Biomedicines
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Sleep-Disordered Breathing and Cardiovascular Diseases
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Sleep-Disordered Breathing and Cardiovascular Diseases

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 4549

Special Issue Editor

Dr. Simon Lebek

E-Mail Website
Guest Editor
1. Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
2. Department of Internal Medicine II, University Hospital Regensburg, 93053 Regensburg, Germany
Interests: sleep-disordered breathing; CRISPR-Cas9 gene editing; heart failure; arrhythmias; translational research; pathomechanisms

Special Issue Information

Dear Colleagues,

Sleep-disordered breathing (SDB) currently affects more than one billion patients worldwide. It is frequently associated with various cardiovascular disorders such as arrhythmias, systolic heart failure, diastolic dysfunction, hypertension, etc. There is an increasing perception that SDB increases cardiovascular morbidity and mortality. Therefore, further study of SDB is urgently warranted.

The aim of this Special Issue is to provide new insights into SDB in the context of cardiovascular disorders. Basic scientific studies delineating pathomechanisms, as well as studies comparing different pathologies (e.g., arrhythmias or diastolic dysfunction) in patients with and without SDB, are of particular interest. Work investigating SDB in the context of cardiovascular interventions and biomarker studies (e.g., blood, ECG) are also welcome. Research in which SDB is found not to be associated with specific diseases or adverse events is also encouraged, as this will provide insights into daily practice. All types of studies and all publication formats will be considered.

Dr. Simon Lebek
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep-disordered breathing (SDB)
  • cardiovascular comorbidities
  • SDB and diastolic dysfunction
  • blood markers
  • ECG markers
  • cardiovascular interventions
  • pathomechanisms in SDB
  • SDB mouse model

Published Papers (4 papers)

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Research

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11 pages, 1408 KiB  
Article
Inflammation and Fibrosis in Sleep-Disordered Breathing after Acute Myocardial Infarction
by Jan Pec, Stefan Buchner, Henrik Fox, Olaf Oldenburg, Stefan Stadler, Lars S. Maier, Michael Arzt and Stefan Wagner
Biomedicines 2024, 12(1), 154; https://doi.org/10.3390/biomedicines12010154 - 11 Jan 2024
Viewed by 825
Abstract
Background: After acute myocardial infarction (AMI), inflammatory processes promote tissue remodeling at the infarct site. Procollagen III amino-terminal propeptide (PIIINP) is a circulating biomarker of type III collagen synthesis that has been shown to be associated with changes in left ventricular ejection fraction [...] Read more.
Background: After acute myocardial infarction (AMI), inflammatory processes promote tissue remodeling at the infarct site. Procollagen III amino-terminal propeptide (PIIINP) is a circulating biomarker of type III collagen synthesis that has been shown to be associated with changes in left ventricular ejection fraction (LVEF) and predicts the occurrence of heart failure after AMI. We hypothesize that sleep-disordered breathing (SDB) promotes inflammation and myocardial fibrosis, leading to reduced myocardial salvage. Therefore, in patients with first-time AMI successfully treated with percutaneous coronary intervention (PCI), we aimed to investigate whether circulating levels of high-sensitivity C-reactive protein (hs-CRP) and PIIINP are elevated in patients with SDB compared to patients without SDB. Methods and Results: This cross-sectional analysis included a total of 88 eligible patients with first AMI and PCI pooled from two prospective studies and stratified according to the apnea–hypopnea index (AHI, with SDB: AHI ≥ 15 h−1). We analyzed circulating levels of hs-CRP and PIIINP 3–5 days after PCI. Patients with SDB had significantly higher levels of hs-CRP (18.3 mg/L [95% CI, 8.0–42.6] vs. 5.8 mg/L [95% CI, 4.2–19.8], p = 0.002) and PIIINP (0.49 U/mL [95% CI, 0.40–0.60] vs. 0.33 U/mL [95% CI, 0.28–0.43], p < 0.001). In a multivariable linear regression model accounting for important clinical confounders, SDB significantly predicted circulating levels of hs-CRP (p = 0.028). Similarly, only SDB was independently associated with PIIINP (p < 0.001). Only obstructive but not central AHI correlated with circulating levels of hs-CRP (p = 0.012) and PIIINP (p = 0.006) levels. Conclusions: The presence of obstructive SDB after AMI was independently associated with increased circulating levels of hs-CRP and PIIINP. Our results emphasize the important role of SDB as a common comorbidity and indicate increased inflammation and myocardial fibrosis in these patients. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Cardiovascular Diseases)
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15 pages, 675 KiB  
Article
Increased Levels of VCAM-1 in Patients with High Cardiovascular Risk and Obstructive Sleep Apnea Syndrome
by Ioana-Maria Chetan, Ștefan Cristian Vesa, Bianca Domokos Gergely, Ruxandra Stefana Beyer, Raluca Tomoaia, Georgiana Cabau, Damiana Maria Vulturar, Dana Pop and Doina Todea
Biomedicines 2024, 12(1), 48; https://doi.org/10.3390/biomedicines12010048 - 24 Dec 2023
Viewed by 780
Abstract
(1) Background: Although obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity, the link between OSA and cardiovascular disease (CVD) is not completely elucidated. Thus, we aim to assess cardiovascular risk (CVR) using SCORE 2 and SCORE 2 for older persons (SCORE [...] Read more.
(1) Background: Although obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity, the link between OSA and cardiovascular disease (CVD) is not completely elucidated. Thus, we aim to assess cardiovascular risk (CVR) using SCORE 2 and SCORE 2 for older persons (SCORE 2OP), and to evaluate the association between the endothelial biomarkers VCAM-1, ICAM-1, epicardial fat, and sleep study parameters in order to improve current clinical practices and better understand the short-and long-term CVRs in OSA patients. (2) Methods: 80 OSA patients and 37 healthy volunteers were enrolled in the study. SCORE2 and SCORE 2 OP regional risk charts (validated algorithms to predict the 10-year risk of first-onset CVD) were used for the analysis of CVR. Two-dimensional echocardiography was performed on all patients and epicardial fat thickness was measured. VCAM-1 and ICAM-1 serum levels were assessed in all patients. (3) Results: OSA patients were classified as being at high CVR, regardless of the type of score achieved. Increased EFT was observed in the OSA group. VCAM-1 was associated with a high CVR in OSA patients, but no significant correlation was observed between adhesion molecules and epicardial fat thickness. (4) Conclusions: OSA patients have a high CVR according to the SCORE 2 and SCORE 2OP risk scores. VCAM-1 may be associated with a high CVR in OSA patients. Extending conventional risk stratification scores by adding other potential biomarkers improves the risk stratification and guide treatment eligibility for CVD prevention in the OSA population. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Cardiovascular Diseases)
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14 pages, 1668 KiB  
Article
Predictors of Nocturnal Hypoxemic Burden in Patients Undergoing Elective Coronary Artery Bypass Grafting Surgery
by Maria Tafelmeier, Verka-Georgieva Blagoeva, Maximilian Trum, Philipp Hegner, Bernhard Floerchinger, Daniele Camboni, Marcus Creutzenberg, Florian Zeman, Christof Schmid, Lars Siegfried Maier, Stefan Wagner, Dominik Linz, Mathias Baumert and Michael Arzt
Biomedicines 2023, 11(10), 2665; https://doi.org/10.3390/biomedicines11102665 - 28 Sep 2023
Viewed by 1176
Abstract
Background: Nocturnal hypoxemia has been linked to increased cardiovascular morbidity and mortality. Several common diseases, such as sleep-disordered breathing (SDB), heart failure (HF), obesity, and pulmonary disease, coincide with an elevated nocturnal hypoxemic burden with and without repetitive desaturations. Research question: This study [...] Read more.
Background: Nocturnal hypoxemia has been linked to increased cardiovascular morbidity and mortality. Several common diseases, such as sleep-disordered breathing (SDB), heart failure (HF), obesity, and pulmonary disease, coincide with an elevated nocturnal hypoxemic burden with and without repetitive desaturations. Research question: This study aimed to evaluate the association of relevant common diseases with distinctive metrics of nocturnal hypoxemic burden with and without repetitive desaturations in patients undergoing coronary artery bypass grafting surgery. Study design and methods: In this subanalysis of the prospective observational study, CONSIDER-AF (NCT02877745) portable SDB monitoring was performed on 429 patients with severe coronary artery disease the night before cardiac surgery. Pulse oximetry was used to determine nocturnal hypoxemic burden, as defined by total recording time spent with oxygen saturation levels < 90% (T90). T90 was further characterized as T90 due to intermittent hypoxemia (T90desaturation) and T90 due to nonspecific and noncyclic SpO2-drifts (T90non-specific). Results: Multivariable linear regression analysis identified SDB (apnea–hypopnea-index ≥ 15/h; B [95% CI]: 6.5 [0.4; 12.5], p = 0.036), obesity (8.2 [2.5; 13.9], p = 0.005), and mild-to-moderate chronic obstructive pulmonary disease (COPD, 16.7 [8.5; 25.0], p < 0.001) as significant predictors of an increased nocturnal hypoxemic burden. Diseases such as SDB, obesity and HF were significantly associated with elevated T90desaturation. In contrast, obesity and mild-to-moderate COPD were significant modulators of T90non-specific. Interpretation: SDB and leading causes for SDB, such as obesity and HF, are associated with an increased nocturnal hypoxemic burden with repetitive desaturations. Potential causes for hypoventilation syndromes, such as obesity and mild-to-moderate COPD, are linked to an increased hypoxemic burden without repetitive desaturations. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT02877745. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Cardiovascular Diseases)
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Review

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16 pages, 1295 KiB  
Review
Insights into the Interaction of Heart Failure with Preserved Ejection Fraction and Sleep-Disordered Breathing
by Michael Wester, Michael Arzt, Frederick Sinha, Lars Siegfried Maier and Simon Lebek
Biomedicines 2023, 11(11), 3038; https://doi.org/10.3390/biomedicines11113038 - 13 Nov 2023
Viewed by 1235
Abstract
Heart failure with preserved ejection fraction (HFpEF) is emerging as a widespread disease with global socioeconomic impact. Patients with HFpEF show a dramatically increased morbidity and mortality, and, unfortunately, specific treatment options are limited. This is due to the various etiologies that promote [...] Read more.
Heart failure with preserved ejection fraction (HFpEF) is emerging as a widespread disease with global socioeconomic impact. Patients with HFpEF show a dramatically increased morbidity and mortality, and, unfortunately, specific treatment options are limited. This is due to the various etiologies that promote HFpEF development. Indeed, cluster analyses with common HFpEF comorbidities revealed the existence of several HFpEF phenotypes. One especially frequent, yet underappreciated, comorbidity is sleep-disordered breathing (SDB), which is closely intertwined with the development and progression of the “obese HFpEF phenotype”. The following review article aims to provide an overview of the common HFpEF etiologies and phenotypes, especially in the context of SDB. As general HFpEF therapies are often not successful, patient- and phenotype-individualized therapeutic strategies are warranted. Therefore, for the “obese HFpEF phenotype”, a better understanding of the mechanistic parallels between both HFpEF and SDB is required, which may help to identify potential phenotype-individualized therapeutic strategies. Novel technologies like single-cell transcriptomics or CRISPR-Cas9 gene editing further broaden the groundwork for deeper insights into pathomechanisms and precision medicine. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Cardiovascular Diseases)
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