Cerebral vasoreactivity in response to a head-of-bed position change is altered in patients with moderate and severe obstructive sleep apnea
| Autor: | Turgut Durduran, Martina Giovannella, Mercedes Mayos, Anna Mola, Ana María Fortuna, Igor Blanco, Gianluca Cotta, Peyman Zirak, Clara Gregori-Pla |
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| Přispěvatelé: | Universitat Politècnica de Catalunya. Institut de Ciències Fotòniques |
| Rok vydání: | 2018 |
| Předmět: |
Male
Supine position Pulmonology Physiology Apnea medicine.medical_treatment lcsh:Medicine Cardiovascular Analysis Polysomnography Pathology and Laboratory Medicine Vascular Medicine Hypercapnia Positive-Pressure Respiration Endocrinology 0302 clinical medicine Blood Flow Medicine and Health Sciences Supine Position Continuous positive airway pressure lcsh:Science Cerebral Blood Flow Assay Clinical Neurophysiology Sleep Apnea Obstructive Multidisciplinary medicine.diagnostic_test Cerebral vasoreactivity Sleep apnea Middle Aged Body Fluids Stroke Chemistry Bioassays and Physiological Analysis Blood Neurology Cerebral blood flow Cerebrovascular Circulation Physical Sciences Cardiology Female Anatomy medicine.symptom Blood Flow Velocity Research Article Chemical Elements Adult medicine.medical_specialty Sleep Apnea Endocrine Disorders Cerebrovascular Diseases Research and Analysis Methods 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Internal medicine Diabetes Mellitus medicine Humans Ischemic Stroke Física [Àrees temàtiques de la UPC] business.industry Microcirculation lcsh:R Biology and Life Sciences Blood flow medicine.disease nervous system diseases respiratory tract diseases Oxygen Obstructive sleep apnea 030228 respiratory system Apnea -- TFG Metabolic Disorders lcsh:Q Clinical Medicine Sleep Disorders business 030217 neurology & neurosurgery |
| Zdroj: | PLoS ONE, Vol 13, Iss 3, p e0194204 (2018) UPCommons. Portal del coneixement obert de la UPC Universitat Politècnica de Catalunya (UPC) PLoS One r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname PLoS ONE Recercat. Dipósit de la Recerca de Catalunya |
| ISSN: | 1932-6203 |
| Popis: | Motivation Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity. Methodology CBF was measured at different head-of-bed position changes (supine to 30 degrees to supine) in sixty-eight patients with OSA grouped according to severity (forty moderate to severe, twenty-eight mild) and in fourteen control subjects without OSA. A subgroup (n = 13) with severe OSA was measured again after two years of CPAP treatment. Results All patients and controls showed a similar CBF response after changing position from supine to 30 degrees (p = 0.819), with a median (confidence interval) change of -17.5 (-10.3, -22.9)%. However, when being tilted back to the supine position, while the control group (p = 0.091) and the mild patients with OSA (p = 0.227) recovered to the initial baseline, patients with moderate and severe OSA did not recover to the baseline (9.8 (0.8, 12.9)%, p < 0.001) suggesting altered cerebral vasoreactivity. This alteration was correlated with OSA severity defined by the apnea-hypopnea index, and with mean nocturnal arterial oxygen saturation. The CBF response was normalized after two years of CPAP treatment upon follow-up measurements. Conclusion In conclusion, microvascular CBF response to a head-of-bed challenge measured by diffuse correlation spectroscopy suggests that moderate and severe patients with OSA have altered cerebral vasoreactivity related to OSA severity. This may normalize after two years of CPAP treatment. |
| Databáze: | OpenAIRE |
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