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Impact of obstructive sleep apnea on cardiopulmonary performance, endothelial dysfunction, and pulmonary hypertension during exercise
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2020-10-01 , DOI: 10.1016/j.resp.2020.103557
Rachel Jen 1 , Jeremy E Orr 2 , Dillon Gilbertson 2 , Janelle Fine 2 , Yanru Li 3 , Darrin Wong 4 , Naa-Oye Bosompra 2 , Susan R Hopkins 5 , Ajit Raisinghani 4 , Atul Malhotra 2
Affiliation  

Rationale

OSA has been associated with reduced exercise capacity. Endothelial dysfunction and exercise-induced pulmonary hypertension (ePH) may be mediators of this impairment. We hypothesized that OSA severity would be associated with impaired exercise performance, endothelial dysfunction, and ePH.

Methods

Subjects with untreated OSA were recruited. Subjects underwent endothelial function, and cardiopulmonary exercise testing with an echocardiogram immediately before and following exercise.

Results

22 subjects were recruited with mean age 56 ± 8 years, 74 % male, BMI 29 ± 3 kg/m2, and AHI 22 ± 12 events/hr. Peak V˙O2 did not differ from normal (99.7 ± 17.3 % predicted; p = 0.93). There was no significant association between OSA severity (as AHI, ODI) and exercise capacity, endothelial function, or pulmonary artery pressure. However, ODI, marker of RV diastolic dysfunction, and BMI together explained 59.3 % of the variability of exercise performance (p < 0.001) via our exploratory analyses.

Conclusions

Exercise capacity was not impaired in this OSA cohort. Further work is needed to elucidate mechanisms linking sleep apnea, obesity, endothelial dysfunction and exercise impairment.



中文翻译:

阻塞性睡眠呼吸暂停对运动过程中心肺功能、内皮功能障碍和肺动脉高压的影响

基本原理

OSA 与运动能力下降有关。内皮功能障碍和运动诱发的肺动脉高压 (ePH) 可能是这种损害的介质。我们假设 OSA 的严重程度与运动表现受损、内皮功能障碍和 ePH 相关。

方法

招募了未经治疗的 OSA 受试者。受试者在运动前后立即接受内皮功能和心肺运动测试,并通过超声心动图进行。

结果

招募了 22 名受试者,平均年龄为 56 ± 8 岁,74% 为男性,BMI 为 29 ± 3 kg/m 2,AHI 为 22 ± 12 个事件/小时。顶峰˙2与正常情况没有区别(预测为 99.7 ± 17.3 %;p = 0.93)。OSA 严重程度(如 AHI、ODI)与运动能力、内皮功能或肺动脉压之间没有显着关联。然而,通过我们的探索性分析,ODI、RV 舒张功能障碍的标志物和 BMI 共同解释了 59.3% 的运动表现变异性(p < 0.001)。

结论

在这个 OSA 队列中,运动能力没有受损。需要进一步的工作来阐明将睡眠呼吸暂停、肥胖、内皮功能障碍和运动障碍联系起来的机制。

更新日期:2020-10-07
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