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Transtornos respiratórios do sono e cardiopatia

Authors: Martinez, Denis; Fuchs, Flávio Danni;

Transtornos respiratórios do sono e cardiopatia

Abstract

Acumularam-se evidências da associação entre transtornos respiratórios do sono (TRS), mais especificamente a síndrome das apnéias-hipopnéias obstrutivas do sono (SAHOS), e cardiopatias. Entretanto, a multiplicidade de pontos ainda por esclarecer torna este tópico atraente como área de pesquisa. Neste artigo, revisam-se os principais TRS e seu papel na hipertensão arterial sistêmica e pulmonar, nas arritmias, na cardiopatia isquêmica e na insuficiência cardíaca congestiva. Descrevem-se, também, as linhas de pesquisa sobre TRS em andamento no Serviço de Cardiologia do Hospital de Clínicas de Porto Alegre (HCPA) O consenso das instituições internacionais que analisam a evidência existente é de que os TRS devem ser insistentemente investigados em pacientes com cardiopatia, principalmente nos casos com roncar no sono, relato de apnéias e sonolência excessiva diurna. O diagnóstico de TRS, em larga escala, entre pacientes com cardiopatias, provavelmente evoluirá para métodos portáteis, facilmente utilizáveis. No presente, não existiriam recursos instalados para realizar polissonografia em todos os casos de enfermidades cardíacas com suspeita de TRS. A eficácia do tratamento da SAHOS como abordagem preventiva e terapêutica nas cardiopatias permanece como importante dúvida.

There is mounting evidence of the association between sleep breathing disorders (SBD), more specifically the obstructive sleep apnea-hypopnea syndrome, and cardiac diseases. However, the multiplicity of points to be clarified makes this topic attractive as a research area. In this article, we review the main SBD and their role in the systemic and pulmonary arterial hypertension, arrhythmias, ischemic coronary disease, and congestive heart failure. We also describe the research topics on SBD currently under investigation in the cardiology service of the Hospital de Clínicas de Porto Alegre. The consensus of international institutions that analyze the existing evidence is that SBD should be constantly investigated in patients with cardiac diseases, mainly in those who snore, report apneas and experience excessive daytime sleepiness. Large scale diagnosis of SBD in patients with cardiac conditions will probably progress towards easily usable portable methods. At the present time, there are no installed facilities to provide polysomnography to all cases of cardiac diseases with suspected SBD. The efficacy of treating SBD as a preventive and therapeutic approach to cardiac diseases is still a considerable doubt.

Keywords

Congestive heart failure, Obstructive sleep apnea syndrome, Hipertensão pulmonar, Insuficiência cardíaca, Arritmia, Systemic hypertension, Apneia obstrutiva do sono, Arrhythmia, Hipertensão, Pulmonary hypertension

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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