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(Circulation. 2007;115:1697.)
© 2007 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	HIGH PREVALENCE OF SLEEP APNEA SYNDROME IN PATIENTS WITH LONG-TERM PACING: THE EUROPEAN MULTICENTER POLYSOMNOGRAPHIC STUDY, by Garrigue et al.

 
Sleep apnea is associated with obesity, heart failure, hypertension, and atrial fibrillation. Although cause-and-effect relationships are still uncertain for some of these associations, treatment may improve hypertension and heart failure in some patients. Sleep apnea also causes transient bradyarrhythmias attributed to increased vagal tone during apnea but has not been associated with daytime bradyarrhythmias. Garrigue and colleagues performed sleep studies in consecutive patients who had received a pacemaker for bradyarrhythmias or heart failure. They found that more than half of the population had sleep apnea, which was often severe. The correlation with recognized clinical markers for sleep apnea was poor, such that many would not be detected with screening questionnaires. The findings should alert clinicians to the high prevalence of sleep apnea in patients with bradyarrhythmias. Further studies are needed to assess cause, effect, and the impact of therapy. See p 1703.

	EARLY AND SUSTAINED BENEFIT ON EVENT-FREE SURVIVAL AND HEART FAILURE HOSPITALIZATION FROM FIXED-DOSE COMBINATION OF ISOSORBIDE DINITRATE/HYDRALAZINE: CONSISTENCY ACROSS SUBGROUPS IN THE AFRICAN-AMERICAN HEART FAILURE TRIAL, by Taylor et al.

 
In the initial report from the African-American Heart Failure Trial (A-HEFT), a fixed-dose combination of isosorbide dinitrate and hydralazine significantly decreased the risk of all-cause death and was associated with a favorable effect on a composite score incorporating mortality as well as heart failure hospitalization and a quality-of-life measure. In this issue of Circulation, the A-HEFT investigators report more extensive analysis of the database. They find that the favorable effect of isosorbide dinitrate and hydralazine on heart failure hospitalizations began relatively early after randomization, in contrast to the later-appearing effect on mortality in the initial report. They also report that the effect on the composite endpoint . . . [Full Text of this Article]

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