Sleep-related breathing disorders in patients with heart failure: current aspects of treatment. Part II

The second part of the review highlights treatments for different types of sleep apnea in patients with heart failure. In both obstructive and central sleep apnea, ventilatory support during sleep takes a special place in treatment. Therefore, the review details the role of different ventilation modes (in particular, CPAP therapy and adaptive servo-ventilation), analyzes available evidence-based medicine data. The role of low-flow oxygen therapy, surgical treatment, implantable devices, specific therapy (theophylline, acetazolamide) in the treatment of central sleep apnea is also shown, and a novel method of treating central sleep apnea is considered — phrenic nerve stimulation

Sleep-related breathing disorders in patients with heart failure with reduced and mildly reduced ejection fraction: main types and their dependence on heart failure etiology

Aim. To identify and study the nature of sleep-related breathing disorders (SBDs) in a cohort of hospitalized patients with heart failure (HF) with reduced and mildly reduced ejection fraction (EF), as well as to clarify the relationship between SBD type, etiology and severity of HF.Material and methods. The study included 117 patients with HF with reduced and mildly reduced ejection fraction hospitalized at the National Medical Research Center for Therapy and Preventive Medicine from 2019 to 2021. All patients underwent clinical and paraclinical examination, including cardiorespiratory sleep study. Patients were divided into three groups according to the type and severity of SBD: no or mild SBD, predominantly with obstructive sleep apnea (OSA) and predominantly with central sleep apnea (CSA). Severity of SBD and clinical data were compared between these groups.Results. A total of 5 patients (4,27%) did not have any SBDs, while 47 (40,17%) were diagnosed with CSA, and 65 (55,56%) — OSA of varying severity. The proportions of patients with moderate and severe CSA and OSA differed insignificantly and amounted to 35,9% (n=42) and 44,4% (n=52), respectively. There were following proportions of diseases related to HF: coronary artery disease (41,88%), nonischemic cardiomyopathy (26,5%), arrhythmogenic cardiomyopathy (15,38%) and other causes (16,24%) (hypertension, myocarditis, heart defects). We found that reduced EF <40%, end-diastolic volume >210 ml, and ventricular ectopy (>300 extrasystoles/day) were associated with CSA, and body mass index >30 kg/m2 was traditionally associated with OSA.Conclusion. More than half of HF patients with reduced and mildly reduced EF have SBDs. Decreased LVEF and ventricular ectopic activity are associated with CSA, while increased body mass index is associated with OSA. Consideration of SBD risk factors may improve patient phenotyping for individualized therapy

Magnetic structural effect in nonequilibrium defective solids

Scientific study of the effect of structural memory of nonequilibrium defective solids about the processing in magnetic field (the magnetic structural effect (MSE) was continued in this paper. The study was aimed to reveal the universal nature of the MSE, which was investigated in several new nonequilibrium defective solids. The results of investigation of the processing in the vortical magnetic field (PVMF) and its effect on the structure of the natural magnetite Fe3O4 and the SnO2 films were presented. The methods of Mössbauer and X-ray spectroscopy were used. The PVMF reduction of a defectiveness of Fe3O4 structure in the magnetite was detected. The MSE was also observed in the Mössbauer spectra of diamagnetic tin oxide SnO2 films after the PVMF. One of the possible explanations of the MSE was given in the paper.Comment: 6 pages, 6 figures, 3 table

Sleep-related breathing disorders in patients with heart failure: classification, epidemiology and pathophysiology. Part I

The problem of heart failure (HF) is one of the central problems in modern cardiology due to its high prevalence among the population and high mortality. In turn, sleep-related breathing disorders (SRBD) are widespread in patients with HF and are associated with both the progression of the underlying disease and a decrease in the quality of life. For the first time, periodic breathing, as one of the types of sleep breathing disorders, was described in patients with HF.Further study of the issue showed a high prevalence of other types of SRBD among patients with HF The article discusses the physiology of sleep breathing monitoring in a healthy person and the pathophysiology of SRBD. The pathogenesis of central sleep apnea and its relationship with HF are discussed in detail. In addition, the mechanisms of the adverse effect of obstructive sleep apnea and HF are highlighted