Relationship between obstructive sleep apnea and pulmonary hypertension: past, present and future.

INTRODUCTION: Obstructive sleep apnea (OSA) is a widely prevalent condition with consequent multiple organ systems complications. There is consensus that OSA is associated with negative effects on pulmonary hemodynamics but whether it contributes to development of clinical pulmonary hypertension (PH) is unclear. AREAS COVERED: In this review, we (1) highlight previous studies looking into the possible bidirectional association of OSA and PH, focusing on those that explore clinical prognostic implications, (2) explore potential pathophysiology, (3) discuss the new metrics in OSA, (4) describe endo-phenotyping of OSA, (5) recommend possible risk assessment and screening pathways. EXPERT OPINION: Relying only on symptoms to consider a sleep study in PH patients is a missed opportunity to detect OSA, which, if present and not treated, can worsen outcomes. The potential prognostic role of sleep study metrics such as oxygen desaturation index (ODI), hypoxic burden (HB) and ventilatory burden (VB) in OSA should be studied in prospective trials to identify patients at risk for PH. AHI alone has not provided clarity. In those with PH, we should consider replacing ambulatory overnight pulse oximetry (OPO) with home sleep studies (HST). In PH patients, mild OSA should be sufficient to consider PAP therapy.

Exploring the Potential of Pulse Transit Time as a Biomarker for Sleep Efficiency through a Comparison Analysis with Heart Rate and Heart Rate Variability.

The relationship between sleep dynamics and blood pressure (BP) changes is well established. Moreover, sleep efficiency and wakefulness during sleep (WASO) events have a significant impact on BP dipping. Despite this knowledge, there is limited research on the measurement of sleep dynamics and continuous blood pressure (CBP). This study aims to explore the relationship between sleep efficiency and cardiovascular function indicators such as pulse transit time (PTT), as a biomarker of CBP, and heart rate variability (HRV), measured using wearable sensors. The results of the study conducted on 20 participants at the UConn Health Sleep Disorders Center suggest a strong linear relationship between sleep efficiency and changes in PTT (r2 = 0.8515) and HRV during sleep (r2 = 5886). The findings of this study contribute to our understanding of the relationship between sleep dynamics, CBP, and cardiovascular health.

Bridging the Gap between the Nanometer-Scale Bottom-Up and Micrometer-Scale Top-Down Approaches for Site-Defined InP/InAs Nanowires.

This work presents a method that bridges the gap between the nanometer-scale bottom-up and micrometer-scale top-down approaches for site-defined nanostructures, which has long been a significant challenge for applications that require low-cost and high-throughput manufacturing processes. We realized the bridging by controlling the seed indium nanoparticle position through a self-assembly process. Site-defined InP nanowires were then grown from the indium-nanoparticle array in the vapor-liquid-solid mode through a "seed and grow" process. The nanometer-scale indium particles do not always occupy the same locations within the micrometer-scale open window of an InP exposed substrate due to the scale difference. We developed a technique for aligning the nanometer-scale indium particles on the same side of the micrometer-scale window by structuring the surface of a misoriented InP (111)B substrate. Finally, we demonstrated that the developed method can be used to grow a uniform InP/InAs axial-heterostructure nanowire array. The ability to form a heterostructure nanowire array with this method makes it possible to tune the emission wavelength over a wide range by employing the quantum confinement effect and thus expand the application of this technology to optoelectronic devices. Successfully pairing a controllable bottom-up growth technique with a top-down substrate preparation technique greatly improves the potential for the mass-production and widespread adoption of this technology.

Acute and chronic oral magnesium supplementation: effects on endothelial function, exercise capacity, and quality of life in patients with symptomatic heart failure.

Endothelial dysfunction is an important pathophysiologic mechanism in the progression of heart failure. The objective of the present study was to determine the effects of acute and chronic oral magnesium supplementation on endothelial function in patients with symptomatic heart failure. Twenty-two symptomatic chronic heart failure patients were randomized to receive 800 mg oral magnesium oxide daily or placebo for 3 months. Data collected included large and small arterial elasticity/compliance, hemodynamic parameters, exercise capacity, and quality-of-life score at baseline, 1 week, and 3 months. Patients who received magnesium had improved small arterial compliance at 3 months from baseline compared with placebo. This study suggests that chronic supplementation with oral magnesium is well tolerated and could improve endothelial function in symptomatic heart failure patients.