Novedades en la epidemiología, la historia natural, el diagnóstico y el tratamiento del síndrome de apneas-hipopneas durante el sueño
Innovations in the Epidemiology, Natural History, Diagnosis and Treatment of Sleep Apnea-Hypopnea Syndrome
Concepción Hernándeza,
, Joaquín Durán-Cantollab, Patricia Lloberesc, Mónica Gonzálezd
Corresponding author
a Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
b Unidad Respiratoria de Trastornos del Sueño, Hospital Txagorritxu, Vitoria, Álava, España
c Servicio de Neumología, Hospital Vall d’Hebron, Barcelona, España
d Unidad de Sueño y Ventilación, Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
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El análisis de los múltiples factores que participan en el riesgo de enfermedad cardiovascular asociada al SAHS ocupa en la actualidad gran parte del interés de la comunidad científica. En este sentido, son numerosos los estudios que ponen de manifiesto el papel de los mediadores inflamatorios e inmunológicos, su relación con el daño endotelial y su influencia en la génesis de enfermedad cardiovascular en pacientes con SAHS. El papel de la CPAP en evitar este riesgo cardiovascular ha tenido resultados diversos. Si bien en la insuficiencia cardíaca no existen evidencias sobre el beneficio o perjuicio de su uso, en el accidente cerebrovascular se ha confirmado el SAHS como factor predisponente y el aumento de mortalidad constatado justificaría el intento de tratar el SAHS en estos pacientes. De igual modo, la reducción de las cifras de presión arterial encontradas en sujetos en tratamiento con CPAP reduciría el riesgo de enfermedad cardiocerebrovascular. Los conocimientos recientes que demuestran la expresión plurifenotípica del SAHS permiten vislumbrar un futuro de enfermedad basado en diferentes fenotipos específicos, donde la tradicional sintomatología que definía el síndrome no limite su tratamiento. Conseguir un método diagnóstico fiable y coste-efectivo, que responda a las demandas del problema de salud pública que representa el SAHS, especialmente en sectores de la población que permanecen más infradiagnosticados y menos conocidos, como los niños, las mujeres y la pobla ción anciana, es otro de los retos que se refleja en los estudios publicados. En resumen, los crecientes conocimientos sobre la biología del SAHS, sus implicaciones cardiovasculares y su repercusión en la morbimortalidad de la población nos permitirán en los próximos años comprender la verdadera dimensión de esta enfermedad.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The following review summarises the most important articles published on sleep apnea-hypopnea syndrome (SAHS) during the current year. The analysis of the many factors implicated in the risk of cardiovascular diseases associated with SAHS is currently of great interest to the scientific community. There are many studies on this subject that demonstrate the role of inflammatory and immunological mediators, their relationship with endothelial damage and their influence in the genesis of cardiovascular disease in patients with SAHS. The role of CPAP in preventing this cardiovascular risk has had varied results. Although there is no evidence of benefit or harm in its use in heart failure, in cerebrovascular accidents SAHS has been confirmed as a predisposing factor and the reported increase in mortality would justify the intention to treat SAHS in these patients. Likewise, the reduction in blood pressure found with CPAP treatment could reduce the risk of cardio-cerebrovascular disease. The recent knowledge that there is expression of multiple phenotypes of SAHS gives a glimpse in the future of a disease based on different specific phenotypes, where the traditional symptomatology that defined the syndrome does not limit its treatment. To obtain a reliable and cost-effective diagnostic method that responds to the demands of the public health problem that is SAHS, particularly in sectors of the population that remain under-diagnosed and less well known, such as children, women and the elderly population is another one of the challenges reflected in published studies. In short, the growing knowledge on the biology of SAHS, its cardiovascular implications and its effect on the morbidity and mortality of the population will enable us to understand the true dimension of this disease in the next few years.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:44 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intermittent hypoxia induces early functional cardiovascular remodelling in mice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Dematteis" 1 => "C. Julián" 2 => "C.H. Guillermet" 3 => "N. Sturm" 4 => "S. Lantuejoul" 5 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 3 | 11 |
| 2024 October | 41 | 26 | 67 |
| 2024 September | 51 | 23 | 74 |
| 2024 August | 53 | 34 | 87 |
| 2024 July | 43 | 22 | 65 |
| 2024 June | 54 | 28 | 82 |
| 2024 May | 45 | 23 | 68 |
| 2024 April | 41 | 36 | 77 |
| 2024 March | 36 | 30 | 66 |
| 2024 February | 29 | 27 | 56 |
| 2023 March | 9 | 3 | 12 |
| 2023 February | 48 | 21 | 69 |
| 2023 January | 32 | 22 | 54 |
| 2022 December | 47 | 35 | 82 |
| 2022 November | 60 | 26 | 86 |
| 2022 October | 46 | 38 | 84 |
| 2022 September | 48 | 27 | 75 |
| 2022 August | 43 | 36 | 79 |
| 2022 July | 32 | 46 | 78 |
| 2022 June | 47 | 36 | 83 |
| 2022 May | 48 | 35 | 83 |
| 2022 April | 57 | 34 | 91 |
| 2022 March | 58 | 39 | 97 |
| 2022 February | 67 | 34 | 101 |
| 2022 January | 26 | 35 | 61 |
| 2021 December | 14 | 38 | 52 |
| 2021 November | 32 | 48 | 80 |
| 2021 October | 44 | 51 | 95 |
| 2021 September | 31 | 60 | 91 |
| 2021 August | 17 | 45 | 62 |
| 2021 July | 27 | 27 | 54 |
| 2021 June | 46 | 44 | 90 |
| 2021 May | 44 | 36 | 80 |
| 2021 April | 147 | 82 | 229 |
| 2021 March | 40 | 20 | 60 |
| 2021 February | 34 | 25 | 59 |
| 2021 January | 24 | 22 | 46 |
| 2020 December | 26 | 19 | 45 |
| 2020 November | 19 | 31 | 50 |
| 2020 October | 17 | 15 | 32 |
| 2020 September | 24 | 14 | 38 |
| 2020 August | 22 | 21 | 43 |
| 2020 July | 30 | 18 | 48 |
| 2020 June | 14 | 9 | 23 |
| 2020 May | 31 | 16 | 47 |
| 2020 April | 31 | 21 | 52 |
| 2020 March | 36 | 20 | 56 |
| 2020 February | 28 | 22 | 50 |
| 2020 January | 40 | 30 | 70 |
| 2019 December | 16 | 19 | 35 |
| 2019 November | 17 | 13 | 30 |
| 2019 October | 13 | 14 | 27 |
| 2019 September | 7 | 12 | 19 |
| 2019 August | 20 | 13 | 33 |
| 2019 July | 17 | 13 | 30 |
| 2019 June | 2 | 7 | 9 |
| 2019 May | 19 | 15 | 34 |
| 2019 April | 20 | 36 | 56 |
| 2019 March | 14 | 26 | 40 |
| 2019 February | 19 | 21 | 40 |
| 2019 January | 13 | 16 | 29 |
| 2018 December | 19 | 20 | 39 |
| 2018 November | 26 | 28 | 54 |
| 2018 October | 39 | 18 | 57 |
| 2018 September | 30 | 8 | 38 |
| 2018 July | 0 | 1 | 1 |
| 2018 May | 6 | 2 | 8 |
| 2018 April | 14 | 8 | 22 |
| 2018 March | 5 | 7 | 12 |
| 2018 February | 5 | 10 | 15 |
| 2018 January | 8 | 9 | 17 |
| 2017 December | 6 | 10 | 16 |
| 2017 November | 11 | 10 | 21 |
| 2017 October | 7 | 18 | 25 |
| 2017 September | 5 | 12 | 17 |
| 2017 August | 13 | 14 | 27 |
| 2017 July | 3 | 4 | 7 |
| 2017 June | 12 | 13 | 25 |
| 2017 May | 22 | 18 | 40 |
| 2017 April | 7 | 6 | 13 |
| 2017 March | 11 | 22 | 33 |
| 2017 February | 7 | 11 | 18 |
| 2017 January | 5 | 8 | 13 |
| 2016 December | 15 | 13 | 28 |
| 2016 November | 15 | 13 | 28 |
| 2016 October | 24 | 25 | 49 |
| 2016 September | 12 | 14 | 26 |
| 2016 August | 12 | 6 | 18 |
| 2016 July | 12 | 5 | 17 |
| 2016 June | 18 | 13 | 31 |
| 2016 May | 19 | 9 | 28 |
| 2016 April | 11 | 0 | 11 |
| 2016 March | 5 | 0 | 5 |
| 2016 February | 4 | 1 | 5 |
| 2016 January | 17 | 12 | 29 |
| 2015 December | 16 | 10 | 26 |
| 2015 November | 33 | 17 | 50 |
| 2015 October | 81 | 1 | 82 |
| 2015 September | 49 | 0 | 49 |
| 2015 August | 53 | 0 | 53 |
| 2015 July | 43 | 0 | 43 |
| 2015 June | 26 | 0 | 26 |
| 2015 May | 53 | 0 | 53 |
| 2015 April | 36 | 0 | 36 |
| 2015 March | 46 | 0 | 46 |
| 2015 February | 24 | 0 | 24 |
| 2015 January | 29 | 0 | 29 |
| 2014 December | 28 | 0 | 28 |
| 2014 November | 30 | 0 | 30 |
| 2014 October | 54 | 0 | 54 |
| 2014 September | 33 | 0 | 33 |
| 2014 August | 42 | 0 | 42 |
| 2014 July | 25 | 0 | 25 |
| 2014 June | 32 | 0 | 32 |
| 2014 May | 46 | 0 | 46 |
| 2014 April | 32 | 0 | 32 |
| 2014 March | 46 | 0 | 46 |
| 2014 February | 43 | 0 | 43 |
| 2014 January | 26 | 0 | 26 |
| 2013 December | 24 | 0 | 24 |
| 2013 November | 24 | 0 | 24 |
| 2013 October | 24 | 0 | 24 |
| 2013 September | 20 | 0 | 20 |
| 2013 August | 49 | 0 | 49 |
| 2013 July | 49 | 0 | 49 |
| 2013 June | 22 | 0 | 22 |
| 2013 May | 17 | 0 | 17 |
| 2013 April | 12 | 0 | 12 |
| 2013 March | 6 | 0 | 6 |
| 2000 January | 1010 | 0 | 1010 |
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