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Special Issue: Current evidence and perspectives for hypertension management in Asia

Impact of sleep-disordered breathing on overnight changes in arterial stiffness in patients with acute heart failure

Hypertension Research volume 47, pages 342–351 (2024)Cite this article

Abstract

Overnight increases in arterial stiffness associated with sleep-disordered breathing may adversely affect patients with acute heart failure. Thus, we investigated overnight changes in arterial stiffness and their association with sleep-disordered breathing in patients hospitalized for acute heart failure. Consecutive patients with acute heart failure were enrolled. All participants underwent overnight full polysomnography following the initial improvement of acute signs and symptoms of acute heart failure. The arterial stiffness parameter, cardio-ankle vascular index (CAVI), was assessed before and after polysomnography. Overall, 60 patients (86.7% men) were analyzed. CAVI significantly increased overnight (from 8.4 ± 1.6 at night to 9.1 ± 1.7 in the morning, P < 0.001) in addition to systolic and diastolic blood pressure (from 114.1 mmHg to 121.6 mmHg, P < 0.001; and from 70.1 mmHg to 78.2 mmHg, P < 0.001, respectively). Overnight increase in CAVI (ΔCAVI ≥ 0) was observed in 42 patients (70%). The ΔCAVI ≥ 0 group was likely to have moderate-to-severe sleep-disordered breathing (i.e., apnea-hypopnea index ≥15, 55.6% vs 80.9%, P = 0.047) and greater obstructive respiratory events (29.4% vs 58.5%, P = 0.041). In multivariable analysis, moderate-to-severe sleep-disordered breathing and greater obstructive respiratory events were independently correlated with an overnight increase in CAVI (P = 0.033 and P = 0.042, respectively). In patients hospitalized for acute heart failure, arterial stiffness, as assessed by CAVI, significantly increased overnight. Moderate-to-severe sleep-disordered breathing and obstructive respiratory events may play an important role in the overnight increase in cardio-ankle vascular index.

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Acknowledgements

The authors are grateful to the staff of all the facilities included in this study.

Funding

This study was partially supported by a Grant-in-Aid for Scientific Research (Grant Number: 26507010); JSPS KAKENHI (Grant Numbers: JP17K09527, JP18K15904, JP21K08116, JP21K16033, JP21K16034); a grant to The Intractable Respiratory Diseases and Pulmonary Hypertension Research Group from the Ministry of Health, Labor and Welfare, Japan (Grant/Award Number: 20FC1027); and a research grant from the Japanese Center for Research on Women in Sport, Juntendo University. These funding sources did not play any other role in this study.

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Authors and Affiliations

  1. Department of Cardiovascular Biology and Medicine, Juntendo University School of Medicine, Tokyo, Japan

    Shoichiro Yatsu, Takatoshi Kasai, Ryo Naito, Hiroki Matsumoto, Azusa Murata, Jun Shitara, Akihiro Sato, Sayaki Ishiwata, Megumi Shimizu, Takao Kato, Shoko Suda, Masaru Hiki & Tohru Minamino

  2. Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan

    Shoichiro Yatsu & Jun Shitara

  3. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Takatoshi Kasai, Ryo Naito, Mitsue Kato & Fusae Kawana

  4. Department of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Takatoshi Kasai & Nanako Shiroshita

  5. Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan

    Takatoshi Kasai

  6. Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan

    Tohru Minamino

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Correspondence to Takatoshi Kasai.

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TK, RN, MK, and FK are affiliated with departments endowed by Philips Respironics, ResMed, and Fukuda Denshi. Dr. TK and NS are affiliated with a department endowed by Paramount Bed.

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Yatsu, S., Kasai, T., Naito, R. et al. Impact of sleep-disordered breathing on overnight changes in arterial stiffness in patients with acute heart failure. Hypertens Res 47, 342–351 (2024). https://doi.org/10.1038/s41440-023-01448-y

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