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Kardiale Auswirkungen der obstruktiven Schlafapnoe

Cardiac effects of obstructive sleep apnea

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Zusammenfassung

Schlafbezogene Atmungsstörungen und insbesondere die obstruktive Schlafapnoe sind mit kardiovaskulären Erkrankungen assoziiert. Derzeit existieren multiple pathophysiologische Erklärungsansätze, welche eine direkte Beeinflussung des kardiovaskulären Systems durch chronisch intermittierende Hypoxämie und intrathorakale Druckschwankungen vermuten lassen. Dabei sollten schlafbezogene Atmungsstörungen im Falle einer „therapieresistenten“ arteriellen Hypertonie, bei nächtlichen Herzrhythmusstörungen, aber auch bei rasch progredienter koronarer Herzerkrankung oder Rezidiven nach Kardioversion des Vorhofflimmerns differenzialdiagnostisch erwogen werden. Besondere Bedeutung kommt den aqnoeassoziierten kardiodepressiven Effekten bei herzinsuffizienten Patienten zu, sodass die Therapie der obstruktive Schlafapnoe in die entsprechenden Therapieleitlinien aufgenommen wurde.

Abstract

Sleep disordered breathing, especially obstructive sleep apnea, are common in cardiovascular disease. Negative hemodynamic effects are mediated by nocturnal ischemia and intrathoracal pressure swings. Therefore “therapy resistant” arterial hypertension and congestive heart failure, as well as atrial fibrillation or sleep associated bradycardia are suggestive of sleep disordered breathing. Further on, clinical course of coronary artery disease seems to be influenced by nocturnal breathing disorders. Application of continuous positive airway pressure (CPAP) is effective in most of the patients and attenuates cardiodepressive hemodynamic effects of obstructive sleep apnea.

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  1. Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    S. Steiner & R. Willinghöfer

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Steiner, S., Willinghöfer, R. Kardiale Auswirkungen der obstruktiven Schlafapnoe. Internist 51, 857–862 (2010). https://doi.org/10.1007/s00108-010-2606-5

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