A relação entre a apneia do sono e doenças cardiovasculares / The relation between sleep apnea and cardiovascular diseases

Letícia Rezende de Morais, Ana Carolina Azevedo de Magalhães, Isabela Lopes Costa, Isabela Pacheco de Arruda Ribeiro, Isabelle de Oliveira Rodrigues, José Rafael Araújo e Costa, Laura Rodrigues Pinto Coelho, Letícia Ribeiro Silva, Vinícius dos Santos Sá Rodrigues

Abstract


INTRODUÇÃO: A apneia do sono ocorre devido ao colabamento das vias aéreas superiores e possui importante associação a doenças cardiovasculares. METODOLOGIA: Trata-se de uma revisão literária realizada por meio de pesquisa na base de dados PubMed, tendo como descritores "sleep apnea syndromes" e "cardiovascular diseases" e publicações nos idiomas inglês e português com disponibilização do texto completo. RESULTADOS: Os estudos ocorreram entre os anos de 2016 e 2020, sendo 2019 o ano de maior índice. Todos os trabalhos são estudos de revisão e dentre os 24 artigos selecionados, 7 foram fundamentais para execução desta pesquisa e destacaram-se como principais referenciais teóricos. DISCUSSÃO: A apneia do sono é uma condição que provoca alterações na fisiologia respiratória, e isso pode acarretar em consequências cardiovasculares. Indivíduos com apneia do sono estão predispostos a diversas afecções cardiovasculares como: hipertensão arterial sistêmica, fibrilação atrial, morte súbita, doença coronariana e consequentemente insuficiência cardíaca, e isso pode ser explicado por diversos mecanismos. CONCLUSÃO: Os estudos mostraram que existe uma intensa correlação entre a apneia do sono e patologias cardiovasculares, que é explicada por alguns eventos que ocorrem no nosso corpo e geram um processo de remodelação da atividade elétrica do coração e também uma remodelação estrutural.


Keywords


“Síndrome da apneia do sono”, “Doenças Cardiovasculares”, “Apneia Obstrutiva do Sono”, “Apneia do Sono Tipo Central”.

References


ANDO, S.I. Influence of hypoxia induced by sleep disordered breathing in case of hypertension and atrial fibrillation. J Cardiol., v.72, n. 1, p. 10-18, jul. 2018.

ANDRADE, F. M.; PEDROSA, R. P. The role of physical exercise in obstructive sleep apnea. J Bras Pneumol, v. 42, n. 6, p. 457-464, 2016.

BELAIDI, E. et al. Targeting the ROS-HIF-1-endothelin axis as a therapeutic approach for the treatment of obstructive sleep apnea-related cardiovascular complications. Pharmacol Ther, v. 168, n. 6, p. 1-11, 2016.

BIBBINS-DOMINGO K. et al. Screening for obstructive sleep apnea in adults: US Preventive Services Task Force recommendation statement. JAMA, v. 317, p. 407–414, 2017.

BOWLES, N.P. et al. Chronotherapy for Hypertension. Curr Hypertens Rep, v. 20, n. 97, p. 37 , 2018.

CHADDA, K.R. et al. Arrhythmogenic mechanisms of obstructive sleep apnea in heart failure patients. Sleep, v. 41, n. 9, 2018.

COWIE MR, GALLAGHER AM. Sleep Disordered Breathing and Heart Failure: What Does the Future Hold? JACC Heart Fail, v. 5, n. 10, p. 715-723, 2017.

DEMPSEY JA, et al. Pathophysiology of sleep apnea. Physiol Rev., v. 90, p. 47–112, 2010.

DRAGER L.F., et al. Sleep Apnea and Cardiovascular Disease: Lessons From Recent Trials and Need for Team Science. Circulation., v. 136, n. 19, p. 1840-1850, 2017.

ECKERT D.J. et al. Eszopiclone increases the respiratory arousal threshold and lowers the apnoea/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold. Clin Sci., v.120, p. 505–514, 2011.

FRIEDMAN. O; LOGAN, A.G. The price of obstructive sleep apnea - hypopnea: hypertension and other ill effects. Am J Hypertens., v. 22, p. 474–83, 2009.

GARCÍA-ORTEGA A., et al. Obstructive sleep apnoea and venous thromboembolism: pathophysiological links and clinical implications. Eur Respir J., v. 53, n. 2, Jan 2019.

HOU, H. et al. Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis. J Glob Health, v. 8, n. 1, p. 1-10, 2018.

HOYOS, C.M.; DRAGER, L.F.; PATEL S.R. OSA and cardiometabolic risk: What's the bottom line? Respirology, v. 22, n. 3, p. 420-429, 2017.

JAVAHERI S. et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol., v. 69, p. 841–858, 2017.

JOHNSON KG, JOHNSON DC. Frequency of sleep apnea in stroke and TIA patients: a meta‐analysis. J Clin Sleep Med., v. 6, p.131–137, 2010.

JORDAN A.S; MCSHARRY, D.G.; MALHOTRA, A. Adult obstructive sleep apnoea. Lancet. v.383, p.736–747, 2014.

KHATTAK H.K., et al. Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis. Tex Heart Inst J., v.45, n. 3, p.151-161, 2018.

KHALYFA A.; CASTRO-GRATTONI, A.L.; GOZAL D. Cardiovascular morbidities of obstructive sleep apnea and the role of circulating extracellular vesicles. Ther Adv Respir Dis., v. 13, jan. 2019.

KOHLER M; STRADLING JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol., v. 7, p.677-85, 2010.

KYGER, M.H et al. Atlas of Clinical Sleep Medicine (2nd edition), Saunders, Philadelphia, PA, p. 316-328, 2014.

MANSUKHANI M.P.; COVASSIN N.; SOMERS V.K. Apneic Sleep, Insufficient Sleep, and Hypertension. Hypertension, v.73, n. 4, p.744-756, abr. 2019.

MARINHEIRO, R. et al. Ventricular Arrhythmias in Patients with Obstructive Sleep Apnea. Current Cardiology Reviews, v. 15, n 1. p. 64-74, 2019.

MARKLUND, M.; BRAEM M.J.A.; VERBRAECKEN J.. Update on oral appliance therapy. Eur Respir Rev, v. 28, n. 153, p. 1-7, 2019.

MAY, A. M.; WAGONER D.R.V.; MEHRA R. OSA and Cardiac Arrhythmogenesis: Mechanistic Insights. Chest Journal, v. 151, n 1. p. 225-241, 2017.

NAUGHTON, M.T.; KEE, K. Sleep apnoea in heart failure: To treat or not to treat? Respirology, v. 22, n. 2, p. 217-229, 2017.

NIETO F.J. et al. Association of sleep - disordered breathing, sleep apnea, and hypertension in a large community - based study. Sleep Heart Health Study. JAMA, v. 283, p. 1829–36, 2000.

PAK, V.M. et al. Mechanisms of reduced sleepiness symptoms in heart failure and obstructive sleep apnea. J Sleep Res, v. 28, n. 5, p. 1-17, 2019.

PEPPARD P.E, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol., v.177, p. 1006–1014, 2013.

SOMERS V.K. et al. Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation scientific statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol., v.52, n. 8, p. 686–717, 2008.

RANDERATH, W. et al. Obstructive sleep apnoea in acute coronary syndrome. Eur Resp Rev, v. 28, n. 1, p. 16, 2019.

SHELL B.; FAULK K.; CUNNINGHAM J.T.. Neural Control of Blood Pressure in Chronic Intermittent Hypoxia. Curr Hypertens Rep., v.18, n. 3, 2016.

TIETJENS JR, et al. Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy. J Am Heart Assoc., v.8, n. 1, jan. 2019.

TOMITA Y., KASAI T. Relationship between cardio-ankle vascular index and obstructive sleep apnea. Rev Cardiovasc Med., v. 21, n.3, p. 353-363, set. 2020.

WELLMAN A, et al. Ventilatory control and airway anatomy in obstructive sleep apnea. Am J Respir Crit Care Med., v. 170, p. 1225–1232, 2004.

YOSHIHISA, A.; TAKEISHI, Y. Heart failure and sleep disordered breathing. Fukushima J Med Sci, v. 63, n. 2, p. 32-38, 2017.

YOSHIHISA, A.; TAKEISHI, Y. Sleep Disordered Breathing and Cardiovascular Diseases. Journal of atherosclerosis and thrombosis, v. 26, n.4, p. 315–327, 2019.




DOI: https://doi.org/10.34119/bjhrv4n2-050

Refbacks

  • There are currently no refbacks.