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Strenth C, Wani A, Alla R, Khan S, Schneider FD, Thakur B. Obstructive Sleep Apnea and Its Cardiac Implications in the United States: An Age-Stratified Analysis Between Young and Older Adults. J Am Heart Assoc 2024; 13:e033810. [PMID: 38842290 DOI: 10.1161/jaha.123.033810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common sleep disorder associated with cardiovascular risks. This study aimed to assess the prevalence of probable OSA and its relationship with cardiovascular risks and diseases focusing on age-stratified young adults (20-40 years) and older (>40 years). METHODS AND RESULTS The study used a cross-sectional design, analyzing data from the National Health and Nutrition Examination Survey conducted between 2013 and 2018, comprising 9887 community-dwelling adults aged ≥20 years. Probable OSA was determined on the basis of self-report of OSA-related symptoms (eg, snoring, gasping/breath cessation while sleeping). Cardiovascular risk factors, including hypertension, diabetes, hyperlipidemia, and metabolic syndrome, were evaluated according to established guidelines. Cardiovascular diseases (CVDs) included self-reported heart conditions, including congestive heart failure, coronary heart disease, angina, heart attacks, and strokes. Individuals with probable OSA showed a significantly higher prevalence of health conditions, including hypertension (adjusted prevalence ratio [aPR], 1.19; P<0.001), diabetes (aPR, 1.17; P: 0.01), metabolic syndrome (aPR, 1.14; P<0.001), heart attack (aPR, 1.63; P<0.01), stroke (aPR, 1.41; P: 0.03), and any CVD event (aPR, 1.36; P: 0.01) after adjusting for relevant factors. Young adults with probable OSA showed higher prevalence rates of any CVD events (aPR, 3.44; P<0.001), hypertension (aPR, 1.45; P<0.001), metabolic syndrome (aPR, 1.25; P<0.001), and angina (aPR, 10.39; P<0.001). CONCLUSIONS The study suggests early identification and management of OSA in individuals at risk for CVD. While cross-sectional, it emphasizes that health care providers should recognize OSA as significantly associated with CVDs and its precursor risks in young adults, stressing proactive care and screening to reduce CVD risk in this population.
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Affiliation(s)
- Chance Strenth
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
| | - Anna Wani
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
| | - Rupini Alla
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
| | - Safia Khan
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
| | - Frank David Schneider
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
| | - Bhaskar Thakur
- Department of Family and Community Medicine University of Texas Southwestern Medical Center Dallas Dallas TX
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Verpalen VA, Ververs FA, Slieker M, Nuboer R, Swart JF, van der Ent CK, Fejzic Z, Westenberg JJ, Leiner T, Grotenhuis HB, Schipper HS. Enhanced aortic stiffness in adolescents with chronic disease is associated with decreased left ventricular global longitudinal strain. IJC HEART & VASCULATURE 2024; 52:101385. [PMID: 38694268 PMCID: PMC11061239 DOI: 10.1016/j.ijcha.2024.101385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/03/2024] [Accepted: 03/07/2024] [Indexed: 05/04/2024]
Abstract
Background The recent Cardiovascular Disease in Adolescents with Chronic Disease (CDACD) study showed enhanced aortic stiffness and wall thickness in adolescents with various chronic disorders. Enhanced aortic stiffness can increase left ventricular (LV) afterload and trigger a cascade of adverse arterioventricular interaction. Here, we investigate the relation between aortic changes and LV function in the CDACD study participants. Methods This cross-sectional study included 114 adolescents 12-18 years old with cystic fibrosis (CF, n = 24), corrected coarctation of the aorta (CoA, n = 25), juvenile idiopathic arthritis (JIA, n = 20), obesity (n = 20), and healthy controls (n = 25). Aortic pulse wave velocity (PWV), which reflects aortic stiffness, and aortic wall thickness (AWT) were assessed with cardiovascular magnetic resonance imaging (CMR). Echocardiography was employed to study conventional markers of LV function, as well as LV global longitudinal strain (LVGLS), which is an established (pre)clinical marker of LV dysfunction. Results First, aortic PWV and AWT were increased in all chronic disease groups, compared to controls. Second, in adolescents with CoA, JIA, and obesity, echocardiography showed a decreased LVGLS, while LV dimensions and conventional LV function markers were similar to controls. Third, multivariable linear regression identified aortic PWV as the most important determinant of their decreased LVGLS (standardized β -0.522, p < 0.001). Conclusions The decreased LVGLS in several adolescent chronic disease groups was associated with enhanced aortic PWV, which might reflect adverse arterioventricular interaction. Whether the decreased LVGLS in the chronic disease groups could negatively impact their long-term cardiovascular outcomes requires further study.
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Affiliation(s)
- Victor A. Verpalen
- Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Cardiovascular Sciences, the Netherlands
| | - Francesca A. Ververs
- Center for Translational Immunology, University Medical Center Utrecht, the Netherlands
| | - Martijn Slieker
- Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Center Amersfoort, the Netherlands
| | - Joost F. Swart
- Department of Pediatric Immunology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
| | - Cornelis K. van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
| | - Zina Fejzic
- Department of Pediatric Cardiology, Amalia Children’s Hospital Radboud University Medical Center Nijmegen, the Netherlands
| | | | - Tim Leiner
- Department of Radiology, Mayo Clinics, United States of America
| | - Heynric B. Grotenhuis
- Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
| | - Henk S. Schipper
- Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, the Netherlands
- Department of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, the Netherlands
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Tao M, Dong X, Tu J, Fang Q, Shao C. Symptom and comorbidity burden in hypertensive patients with obstructive sleep apnea. Front Endocrinol (Lausanne) 2024; 15:1361466. [PMID: 38501097 PMCID: PMC10944929 DOI: 10.3389/fendo.2024.1361466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
Background Obstructive sleep apnea (OSA) is an important but frequently overlooked risk factor for hypertension (HTN). The prevalence of hypertension is high in patients with OSA, but the differences in clinical symptoms and comorbidities between patients with OSA with hypertension and those with normal blood pressure have not been fully defined. Methods This study retrospectively analyzed OSA patients diagnosed for the first time in Lihuili Hospital Affiliated to Ningbo University from 2016 to 2020. Patients were divided into an OSA group with hypertension and an OSA group without hypertension. The sociodemographic information, clinical symptoms, comorbidities, and polysomnography results of the two groups were compared. The independent risk factors associated with hypertension in patients with OSA were explored. Results A total of 1108 patients with OSA initially diagnosed were included in the study, including 387 with hypertension and 721 without. Compared with OSA patients without hypertension, OSA patients with hypertension were older; had a higher body mass index (BMI) and Epworth sleepiness score (ESS); a higher incidence of nocturia; and a higher proportion of diabetes mellitus, coronary heart disease, and cerebrovascular disease. Multivariate analysis showed age (odds ratio [OR]:1.06, 95% confidence interval [CI]:1.04-1.08), BMI (OR:1.17, 95% CI:1.11-1.23), ESS score (OR:0.97, 95%CI: 0.94-1.00) and nocturia symptoms (OR:1.64, 95% CI:1.19-2.27) was independently associated with hypertension in OSA patients, and comorbid diabetes (OR: 3.86, 95% CI: 2.31-6.45), coronary heart disease (OR: 1.90, 95% CI:1.15-3.16), and ischemic stroke (OR: 3.69,95% CI:1.31-10.40) was independently associated with hypertension in OSA patients. Conclusion Compared to OSA patients with normal blood pressure, OSA patients with hypertension had more significant daytime sleepiness, more frequent nocturnal urination, and a higher risk of diabetes, coronary heart disease, and cerebrovascular disease.
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Affiliation(s)
- MengShi Tao
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Xiaoqi Dong
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Jinjing Tu
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Qing Fang
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Chuan Shao
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
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Taherifard E, Taherifard E, Hosseini-Bensenjan M, Sayadi M, Haghpanah S. The Prevalence of Obstructive Sleep Apnea and Associated Symptoms among Patients with Sickle Cell Disease: A Systematic Review and Meta-analysis. Hemoglobin 2023; 47:215-226. [PMID: 38102839 DOI: 10.1080/03630269.2023.2290507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
Previous studies have shown that patients with sickle cell disease (SCD) are at high risk for obstructive sleep apnea (OSA). In the current study, we aimed to systematically review the literature to address the prevalence of OSA and associated symptoms among patients with SCD. Electronic databases, including Web of Science, Scopus, PubMed, Google Scholar, and Embase were systematically searched to identify the relevant original articles on patients with SCD. Newcastle Ottawa scale was used for quality assessment. Data were pooled by using random effects models. Subgroup analyses were performed by age groups. Thirty-nine studies containing details of 299,358 patients with SCD were included. The pooled results showed that more than half of these patients had OSA with different severities. The prevalence rates of OSA among children with apnea hypopnea index (AHI) cutoffs of above 1, 1.5, and 5 were 51% (95% confidence interval (CI) 36-67%), 29% (95% CI 19-40%), and 18% (95% CI 14-23%), respectively. The prevalence of OSA among adults with AHI cutoff of 5 was 43% (95% CI 21-64%). The pooled rates of snoring, nocturnal enuresis, nocturnal desaturation, and daytime sleepiness were 55% (95% CI 42-69%), 37% (95% CI 33-41%), 49% (95% CI 26-72%), and 21% (95% CI 12-30%), respectively. Given the high prevalence of OSA in patients with SCD, probable greater burden of SCD complications, and irreversible consequences of OSA, screening for OSA symptoms and signs seems useful in these patients. By screening and identifying this heterogeneous disorder earlier, available treatment modalities can be individualized for each patient.
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Affiliation(s)
- Ehsan Taherifard
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Taherifard
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mehrab Sayadi
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Higher Hospital Frailty Risk Score Is an Independent Predictor of In-Hospital Mortality in Hospitalized Older Adults with Obstructive Sleep Apnea. Geriatrics (Basel) 2022; 7:geriatrics7060127. [PMID: 36412616 PMCID: PMC9680342 DOI: 10.3390/geriatrics7060127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/30/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Frailty predisposes individuals to stressors, increasing morbidity and mortality risk. Therefore, this study examined the impact of frailty defined by the Hospital Frailty Risk Score (HFRS) and other characteristics in older hospitalized patients with Obstructive Sleep Apnea (OSA). Methods: We conducted a retrospective study using the National Inpatient Sample 2016 in patients ≥65 years old with OSA. Logistic regression was used to evaluate the impact of frailty on inpatient mortality. A Kaplan-Meier curve with a log-rank test was used to estimate survival time between frailty groups. Results: 182,174 discharge records of elderly OSA were included in the study. 54% of the cohort were determined to be a medium/high frailty risk, according to HFRS. In multivariable analysis, frailty was associated with a fourfold (medium frailty, adjusted odd ratio (aOR): 4.12, 95% Confidence Interval (CI): 3.76−4.53, p-value < 0.001) and sixfold (high frailty, OR: 6.38, 95% CI: 5.60−7.27, p-value < 0.001) increased odds of mortality. Hospital survival time was significantly different between the three frailty groups (Log-rank test, p < 0.0001). Comorbidity burden defined by Charlson comorbidity Index (CCI) was associated with increased mortality (p < 0.001). Conclusion: More than half of the whole cohort was determined to be at medium and high frailty risk. Frailty was a significant predictor of in-hospital deaths in hospitalized OSA patients. Frailty assessment may be applicable for risk stratification of older hospitalized OSA patients.
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Suzuki M, Shimamoto K, Tatsumi F, Tsuji T, Satoya N, Inoue Y, Hoshino T, Shiomi T, Hagiwara N. Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea. J Int Med Res 2022; 50:3000605221121941. [PMID: 36124891 PMCID: PMC9500274 DOI: 10.1177/03000605221121941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Rapid eye movement (REM) obstructive sleep apnea (OSA) is associated with the
risk of cardiovascular events. Arterial stiffness and carotid artery
intima-media thickness (IMT) predict these events, but few relevant studies
have been conducted. We compared long-term changes in arterial stiffness and
IMT between patients with REM OSA and non-REM (NREM) OSA receiving
continuous positive airway pressure (CPAP) or oral appliance (OA)
therapy. Methods Newly diagnosed female patients with OSA received CPAP (n = 6) or OA (n = 7).
Pulse wave velocity (PWV) and carotid artery ultrasound were performed
before and 60 months after treatment. Results There were no differences in baseline characteristics (mean age: 56.0 vs.
61.3 years; mean body mass index: 22.6 vs. 21.7 kg/m2) between
the REM OSA and non-REM OSA groups. The median apnea-hypopnea index was
lower in the REM OSA group than in the non-REM OSA group. Increased PWV
(12.92 ± 1.64 to 14.56 ± 2.73 m/s) and deteriorated glucose metabolism were
observed in the REM OSA group after treatment. PWV, IMT, and cardiovascular
risk factors were unaffected in the non-REM OSA group. Conclusion Arterial stiffness and glucose metabolism are deteriorated in patients with
REM OSA compared with these parameters in patients with non-REM OSA after
CPAP or OA treatment.
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Affiliation(s)
- Mayumi Suzuki
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan
| | | | | | | | | | - Yuji Inoue
- Central Clinical Laboratory, TWMU, Tokyo, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Hoshino ENT and Sleep Disordered Breathing Center, Hyogo, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuhisa Hagiwara
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan.,Department of Cardiology, TWMU, Tokyo, Japan
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Xu W, Yang YM, Zhu J, Wu S, Wang J, Zhang H, Shao XH, Mo R, Tan JS, Wang JY. Clinical characteristics and thrombotic risk of atrial fibrillation with obstructive sleep apnea: results from a multi-center atrial fibrillation registry study. BMC Cardiovasc Disord 2022; 22:331. [PMID: 35879670 PMCID: PMC9310481 DOI: 10.1186/s12872-022-02773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep apnea is a risk factor for atrial fibrillation (AF) but it is underdiagnosed. Whether obstructive sleep apnea (OSA) is correlated with thrombotic risk in AF remains unclear. The aim of the present study was to analyze the clinical characteristics and assess the thrombotic risk of AF with OSA. METHODS In the present registry study,1990 consecutive patients with AF from 20 centers were enrolled. The patients were divided into 2 groups depending on whether they presented with both AF and OSA. All the patients were followed up for 1 year to evaluate the incidences of stroke and non-central nervous system (CNS) embolism. RESULTS Of the 1990 AF patients, 70 (3.5%) and 1920 (96.5%) patients were in the OSA group and non-OSA group, respectively. The results of the multivariate logistic model analysis showed that male sex, body mass index (BMI), smoking, and major bleeding history were independent risk factors for patients with AF and OSA. The comparison of the Kaplan-Meier curves using the log-rank test revealed that AF with OSA was correlated with an increased risk of non-CNS embolism (p < 0.01). After multivariate adjustments were performed, OSA remained an independent risk factor for non-CNS embolism (HR 5.42, 95% CI 1.34-22.01, p = 0.02), but was not correlated with the risk of stroke in patients with AF. CONCLUSIONS The present study revealed that male sex, high BMI values, smoking, and major bleeding history were independent risk factors for patients with AF and OSA. Moreover, OSA was an independent risk factor for non-CNS embolism in AF. Our results indicate that non-CNS embolism requires focus in patients with AF and OSA.
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Affiliation(s)
- Wei Xu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Yan-Min Yang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China.
| | - Jun Zhu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Shuang Wu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Juan Wang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Han Zhang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Xing-Hui Shao
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Ran Mo
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Jiang-Shan Tan
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Jing-Yang Wang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
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Anghel R, Adam CA, Marcu DTM, Mitu O, Roca M, Tinica G, Mitu F. Cardiac Rehabilitation in Peripheral Artery Disease in a Tertiary Center-Impact on Arterial Stiffness and Functional Status after 6 Months. Life (Basel) 2022; 12:life12040601. [PMID: 35455092 PMCID: PMC9024562 DOI: 10.3390/life12040601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 12/12/2022] Open
Abstract
Background and Objectives: Cardiac rehabilitation (CR) plays an essential role in peripheral artery disease (PAD), leading to improved functional status, increased quality of life, and reduced arterial stiffness. We aimed to assess factors associated with clinical improvement 6 months after enrolment in a rehabilitation program at an academic medical center in north-eastern Europe. Materials and Methods: We conducted a prospective cohort study on 97 patients with PAD admitted to a single tertiary referral center. At the 6-months follow-up, 75 patients (77.3%) showed improved clinical status. We analyzed demographics and clinical and paraclinical parameters in order to explore factors associated with a favorable outcome. Results: Hypertension (p = 0.002), diabetes mellitus (p = 0.002), dyslipidemia (p = 0.045), and obesity (p = 0.564) were associated with no clinical improvement. Smoking cessation (p < 0.001), changing sedentary lifestyle (p = 0.032), and improvement of lipid and carbohydrate profile as well as functional status parameters and ambulatory arterial stiffness index (p = 0.008) were factors associated with clinical improvement at the 6-months follow-up. Conclusions: PAD patients require an integrative, multidisciplinary management to maintain functional status and increase quality of life. Improving carbohydrate and lipid profile, adopting a healthy lifestyle, quitting smoking and increasing exercise capacity are predictors for clinical improvement 6 months after enrolment in a CR program.
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Affiliation(s)
- Razvan Anghel
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Cristina Andreea Adam
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
| | - Dragos Traian Marius Marcu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Ovidiu Mitu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
- “Sf. Spiridon” Clinical Emergency Hospital, Independence Boulevard nr 1, 700111 Iași, Romania
- Correspondence:
| | - Mihai Roca
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Grigore Tinica
- Department of Cardiovascular Surgery, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
- Institute of Cardiovascular Diseases “Prof. Dr. George I.M. Georgescu”, 700503 Iași, Romania
| | - Florin Mitu
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
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