A Machine Learning-Derived Score to Effectively Identify Heart Failure With Preserved Ejection Fraction.

Background: The diagnosis of heart failure with preserved ejection fraction (HFpEF) in the clinical setting remains challenging, especially in patients with obesity.

Objectives: This study aimed to identify novel predictors of HFpEF well suited for patients with obesity.

Methods: We performed a retrospective analysis of a well-characterized cohort of patients with obesity with HFpEF (n = 404; mean body mass index [BMI] 36.

Relationship Between Myocardial NPPB Expression and Serum NT-proBNP in Heart Failure With Preserved Ejection Fraction.

“Low serum NT-proBNP in obese #HFpEF is related to lower myocardial synthesis at same hemodynamic load. #HFpEF thresholds for serum proBNP bias towards worse renal dz, less severe #obesity, worse #PH, impacting efficacy/generalizability.”

Rest-Activity Rhythm Is Associated With Obesity Phenotypes: A Cross-Sectional Analysis.

Background: The prevalence of obesity continues to increase in spite of substantial efforts towards its prevention, posing a major threat to health globally. Circadian disruption has been associated with a wide range of preclinical and clinical disorders, including obesity. However, whether rest-activity rhythm (RAR), an expression of the endogenous circadian rhythm, is associated with excess adiposity is poorly understood.

Waist-To-Hip Ratio Predicts Abnormal Overnight Oximetry in Men Independent of Body Mass Index.

Ambulatory overnight oximetry (OXI) has emerged as a cost-effective initial test for sleep disordered breathing. Obesity is closely associated with obstructive sleep apnea (OSA); however, whether body mass index (BMI) or waist-to-hip ratio (WHR) predicts abnormal overnight OXI remains unknown. We performed a retrospective cross-sectional study of 393 men seen in the Executive Health Program at Mayo Clinic in Rochester, Minnesota who underwent ambulatory overnight OXI ordered by preventive medicine physicians between January 1, 2004 through December 31, 2010.

Sleep Duration and Hypertension: Epidemiological Evidence and Underlying Mechanisms.

While the contribution of several physiological systems to arterial blood pressure regulation has been studied extensively, the role of normal and disrupted sleep as a modifiable determinant of blood pressure control, and in the pathophysiology of hypertension, has only recently emerged. Several sleep disorders, including sleep apnea and insomnia, are thought to contribute to the development of hypertension, although less attention is paid to the relationship between sleep duration and blood pressure independent of sleep disorders per se. Accordingly, this review focuses principally on the physiology of sleep and the consequences of abnormal sleep duration both experimentally and at the population level.

Obstructive Sleep Apnea as a Cardiovascular Risk Factor-Beyond CPAP.

Patients with obstructive sleep apnea (OSA) experience repetitive partial or complete airway collapse during sleep resulting in nocturnal hypoxia-normoxia cycling, and are at increased cardiovascular risk. The number of apneas and hypopneas indexed per hour of sleep (apnea-hypopnea index) along with the associated intermittent hypoxia predict the increased cardiovascular risk; thus, their attenuation or prevention are objectives of OSA therapy. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA and, when effective, mitigates the apnea-hypopnea index and hypoxemia.

Sleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population.

Sleep apnea is very common in patients with cardiovascular disease, especially in patients with hypertension. Over the last few decades a number of discoveries have helped support a causal relationship between the two and even resistant hypertension. The role neurogenic mechanisms play has gathered more attention in the recent past due to their immediate bedside utility.