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Minerva Pneumologica 2017 June;56(2):69-77

DOI: 10.23736/S0026-4954.17.01778-3


lingua: Inglese

Influences of obstructive sleep apnea on acute cardiac changes associated with a Mueller maneuver challenge test

Adrian ARON 1, 2, William G. HERBERT 1, Donald ZEDALIS 3

1 Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, USA; 2 Department of Physical Therapy, Radford University, Radford, VA, USA; 3 Sleep Disorders Network of Southwest Virginia, Christiansburg, VA, USA


BACKGROUND: The aim of this study was to determine the unique obstructive sleep apnea hypopnea syndrome (OSAHS) dynamic cardiac responses to negative intrathoracic pressure (Mueller maneuver).
METHODS: After inclusion criteria were met, cardiac monitoring was performed using a non-invasive bioimpedance device. OSAHS and control subjects underwent two 30 sec Mueller maneuvers (MM) to assess cardiac output (CO), heart rate (HR), stroke volume (SV), myocardial contractility (MCI), and systemic vascular resistance (SVR).
RESULTS: During MM, there were similar changes in SV, HR, and SVR in both groups. CO decreased by nearly 12% during MM in controls but not altered from the normal breathing values in the OSAHS groups. In contrast, MCI was increased by almost 5% above normal breathing values in the OSAHS group, but was not significantly changed in controls. Changes in MCI were predicted by AHI and systolic blood pressure (R2=0.58, P<0.03 and R2=0.47, P<0.001, respectively). During 3 min after resumption of normal breathing following MM, in the OSAHS group cardiac responses rapidly returned to baseline within 30 sec, while the control group had a normal compensatory increase and returned to normal after 2 minutes.
CONCLUSIONS: Subjects suffering from OSAHS may display a blunted hemodynamic response to a respiratory challenge of MM. Performing a simple cardiac monitoring test can help improve the clinical treatment algorithm of OSAHS patients.

KEY WORDS: Cardiac imaging techniques - Sleep apnea syndromes - Hemodynamics

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