This study was done to evaluate whether cardiac dysfunction or abnormal measurements on cardiopulmonary exercise testing (CPET) can be improved after 2 months of nasal CPAP treatment. Twenty patients with moderate or severe OSAS received nasal CPAP treatment. All subjects also underwent blood pressure, simple spirometric, and arterial blood gas (ABG) measurements; cardiac evaluation by radionuclide scanning and CPET; and an overnight polysomnography sleep study before and after nasal CPAP treatment. No difference in left ventricular ejection fraction (LVEF) was found after 2 months of nasal CPAP treatment, but higher right ventricular ejection fraction (RVEF), VO2peak, VO2peak/kg and workpeak were observed. After 2 months of nasal CPAP treatment, these patients had a lower breathing reserve and a greater increase in anaerobic threshold and oxygen pulse. Moderate to severe OSAS patients before nasal CPAP treatment had abnormal CPET as reflected by lower RVEF, VO2peak/kg, workpeak, anaerobic threshold and oxygen pulse. These abnormalities can be improved after 2 months of nasal CPAP treatment.
The aim of the study was to evaluate the effects of successful laser-assisted uvulopalatoplasty (LAUP) on oral airway resistance (R(OA)) during wakefulness in patients with OSAS. Fifteen healthy subjects (group I) and 25 subjects (group II) with moderately severe or severe obstructive sleep apnea syndrome (OSAS) proven by an overnight sleep study and who desired LAUP were enrolled. All underwent an overnight sleep study, pulmonary function testing and measurement of oral airway resistance [R(OA) (including impedance (Zrs), resistance (R) and reactance (X)] measurement by Impulse Oscillometry (IOS) (MasterScreen IOS, VIASYS Healthcare GmbH, Germany) in the upright (seated) position and then in the supine position while awake. Group II subjects had these measurements twice, both before and 3 months after LAUP. Based on the assessment of their sleep study after LAUP, they were divided into two groups: responders (group IIa) and nonresponders (group IIb). Zrs was normal in the sitting position both before and after LAUP in both groups IIa and IIb and comparable to that of group I controls. There was an increase in Zrs in the supine position in both groups IIa and IIb subjects before LAUP. After LAUP, the Zrs in group IIb subjects remained elevated, while that in group IIa subjects returned to levels comparable to those in the normal controls. OSAS patients before LAUP have abnormal R(OA) in the supine position as reflected by a high Zrs. The Zrs is improved after LAUP that successfully ameliorates OSAS.
Patients with OSAS before LAUP had abnormal CPET as reflected by low VO2peak/kg, WRmax, anaerobic threshold, and oxygen pulse. All of these variables improved after LAUP that successfully ameliorated OSAS.
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