Systolic pressure response to voluntary apnea predicts sympathetic tone in obstructive sleep apnea as a clinically useful index.

Autor: Jouett NP; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States., Hardisty JM; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States., Mason JR; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States., Niv D; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States., Romano JJ; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States., Watenpaugh DE; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States; Sleep Consultants of Texas, 1521 Cooper St., Fort Worth, TX 76104, United States., Burk JR; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States; Sleep Consultants of Texas, 1521 Cooper St., Fort Worth, TX 76104, United States., Smith ML; Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States. Electronic address: michael.smith@unthsc.edu.
Jazyk: angličtina
Zdroj: Autonomic neuroscience : basic & clinical [Auton Neurosci] 2016 Jan; Vol. 194, pp. 38-45. Date of Electronic Publication: 2015 Dec 09.
DOI: 10.1016/j.autneu.2015.12.003
Abstrakt: The present investigation tested the hypotheses that systolic arterial pressure (SAP) responses to voluntary apnea (a) serve as a surrogate of sympathetic nerve activity (SNA), (b) can distinguish Obstructive Sleep Apnea (OSA) patients from control subjects and (c) can document autonomic effects of treatment. 9 OSA and 10 control subjects were recruited in a laboratory study; 44 OSA subjects and 78 control subjects were recruited in a clinical study; and 21 untreated OSA subjects and 14 well-treated OSA subjects were recruited into a treatment study. Each subject performed hypoxic and room air voluntary apneas in triplicate. Muscle SNA (MSNA) and continuous AP were measured during each apnea in the laboratory study, while systolic arterial pressure (SAP) responses were measured continuously and by standard auscultation in the clinical and treatment studies. OSA subjects exhibited increased mean arterial pressure (MAP), SAP and MSNA responses to hypoxic apnea (all P<0.01) and the SAP response highly correlated with the MSNA response (R(2)=0.72, P<0.001). Clinical assessment confirmed that OSA subjects exhibited markedly elevated SAP responses (P<0.01), while treated OSA subjects had a decreased SAP response to apnea (P<0.04) compared to poorly treated subjects. These data indicate that (a) OSA subjects exhibit increased pressor and MSNA responses to apnea, and that (b) voluntary apnea may be a clinically useful assessment tool of autonomic dysregulation and treatment efficacy in OSA.
(Copyright © 2015 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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