Hemodynamic Consequences of Obstructive Sleep Apnea

Jw, Weiss; Remsburg, S; Garpestad, Erik; Ringler, J.; Sparrow, David; Ja, Parker

doi:10.1093/sleep/19.5.388

Cited by 110 publications

(71 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HR increases after apnea termination are related, at least in part, to nonvagally mediated reflexes. apnea; vagus; hemodynamics OBSTRUCTIVE SLEEP APNEA is a relatively common clinical condition in which upper airway collapse and cessation of airflow produce an acute cardiovascular response, including elevations in blood pressure as well as changes in heart rate and ventricular function (3,24,26). In general, cardiovascular variables fluctuate during the apnea-interapnea periods because of mechanical alterations and reflex changes in autonomic tone.…”

mentioning

confidence: 99%

Effects of vagotomy on cardiovascular response to periodic apneas in sedated pigs

Slamowitz

Chen

Scharf

1999

Journal of Applied Physiology

View full text Add to dashboard Cite

Slamowitz, D., L. Chen, and S. M. Scharf. Effects of vagotomy on cardiovascular response to periodic apneas in sedated pigs. J. Appl. Physiol. 86(6): 1890-1896, 1999There are few studies investigating the influence of vagally mediated reflexes on the cardiovascular response to apneas. In 12 sedated preinstrumented pigs, we studied the effects of vagotomy during apneas, controlling for apnea periodicity and thoracic mechanical effects. Nonobstructive apneas were produced by paralyzing and mechanically ventilating the animals, then turning the ventilator off and on every 30 s. Before vagotomy, relative to baseline, apnea caused increased mean arterial pressure (MAP; ϩ19 Ϯ 25%, P Ͻ 0.05), systemic vascular resistance (SVR; ϩ33 Ϯ 16%, P Ͻ 0.0005), and heart rate (HR; ϩ5 Ϯ 6%, P Ͻ 0.05) and decreased cardiac output (CO) and stroke volume (SV; Ϫ16 Ϯ 10% P Ͻ 0.001). After vagotomy, no significant change occurred in MAP, SVR, and SV during apneas, but CO and HR increased relative to baseline. HR was always greater (ϳ14%, P Ͻ 0.01) during the interapneic interval compared with during apnea. We conclude that vagally mediated reflexes are important mediators of the apneic pressor response. HR increases after apnea termination are related, at least in part, to nonvagally mediated reflexes. apnea; vagus; hemodynamics OBSTRUCTIVE SLEEP APNEA is a relatively common clinical condition in which upper airway collapse and cessation of airflow produce an acute cardiovascular response, including elevations in blood pressure as well as changes in heart rate and ventricular function (3,24,26). In general, cardiovascular variables fluctuate during the apnea-interapnea periods because of mechanical alterations and reflex changes in autonomic tone. Reflex effects leading to changes in autonomic tone may be activated through 1) changes in thoracic mechanics from obstructed respiratory efforts (4), 2) changes in blood-gas tensions (hypoxia and/or hypercapnia) (12, 18), and 3) postapneic arousals. These factors ultimately culminate in an increase in sympathoadrenal tone (9, 13), which is associated with a pressor response during the apnea and postapnea periods. Studies to date have focused mainly on the relative effect of these physiological alterations with regard to the overall cardiovascular response to apneas. However, few studies have examined specific autonomic pathways mediating this response. In particular, little is known about the relative contribution of vagal traffic in the modulation of the sympathetic response. The vagus nerve could play a prominent role in the cardiovascular response to apneas because of afferent and/or efferent autonomic signals carried within the nerve. Sensory afferent signals from aortic receptors (baroreceptors and/or chemoreceptors) or mechanoreceptors carried via the vagus could be responsible for the augmentation in sympathetic tone during apneas (1, 25). In addition, mechanoreceptor afferents carried via the vagus could increase sympathetically mediated responses through an arousal mechanism (11,14)....

show abstract

mentioning

confidence: 99%

Effects of vagotomy on cardiovascular response to periodic apneas in sedated pigs

Slamowitz

Chen

Scharf

1999

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…14 OSA itself is a disorder associated with increased cardiovascular mortality and morbidity. 5,23 Therefore, it must be assumed that the vast majority of patients with resistant hypertension and OSA are exposed in the long term to high cardiovascular risk. Most of the published studies analyzed the impact of OSA on LV morphology and function, and the negative effects of uncontrolled hypertension and severe OSA on the left ventricle have been broadly investigated.…”

Section: Polysomnographymentioning

confidence: 99%

Pulmonary artery dilation indicates severe obstructive sleep apnea in patients with resistant hypertension: the Resist-POL Study

Dobrowolski¹,

Florczak²,

Klisiewicz³

et al. 2016

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

“…A conseqüência cardiovascular da SAHOS pode ser aguda ou crônica; o aumento do esforço respiratório durante o colapso faringeano produz uma diminuição substancial na pressão intratorácica a qual contribui para aumento da pré-carga cardíaca e pós-carga ventricular esquerda. Ao término de um episódio de apnéia pode haver aumento do volume sistólico sobre uma vasoconstrição simpática que pode elevar inten-samente a pressão arterial durante a noite 28 . Cronicamente a SAHOS pode levar a períodos de hipertensão arterial sistêmica sustentada, cujo mecanismo provavelmente inclui: excitação simpática, reduzida atividade parassimpática e liberação de endotelina 29 .…”

Section: -Impacto Das Apnéias Obstrutivas Do Sono Sobre a Função Carunclassified

Síndrome Das Apnéias / Hipopnéias Obstrutivas Do Sono (Sahos)

Silva¹,

Giacon²

2006

Medicina (Ribeirão Preto)

View full text Add to dashboard Cite

RESUMO:Os distúrbios respiratórios do sono constituem um tópico relativamente novo do conhecimento científico, cujo manejo envolve a participação de diversas Disciplinas da área Médi-ca. Sua importância tem crescido desde a disponibilização em escala "democrática" dos recursos diagnósticos e terapêuticos que se iniciou no começo dos anos de 1980. Isso permitiu constatações sucessivas do papel do sono e dos seus distúrbios no aumento da morbidade e da mortalidade. A prevalência também tem aumentado desde os primeiros levantamentos epidemiológicos em adultos, em parte devido ao aumento dos fatores de risco, principalmente a obesidade e idade, mas também ao melhor reconhecimento de anormalidades devido ao aumento na sensibilidade dos métodos diagnósticos utilizados. As apnéias/hipopnéias do sono têm se revelado ser o mais importante e freqüente distúrbio respiratório do sono, constituindo cerca de 80% dos casos que procuram as Clínicas dedicadas a estudar as anormalidades do sono. Descritores 1-INTRODUÇÃO Sinonímia: Síndrome das Apnéias do Sono (SAS) Síndrome das Apnéias Obstrutivas do Sono (SAOS)A síndrome das apnéias/hipopnéias do sono tem se revelado ser o mais importante e freqüente distúr-bio respiratório do sono. Decorre de oclusão ou semioclusão repetidas das Vias Aéreas Superiores (VAS) durante o sono produzindo pausas na respiração, de duração variável. O distúrbio é comum e acomete todas as faixas etárias e ambos os sexos, independentemente do peso, embora seja mais freqüente nos obesos ou sobrepeso.O interesse pelas apnéias do sono ganhou vulto a partir do final dos anos de 1970 após 30 anos de significantes estudos e descobertas que alavancaram a importância do sono e seus distúrbios, sobre a saúde.

show abstract

Hemodynamic Consequences of Obstructive Sleep Apnea

Cited by 110 publications

References 0 publications

Effects of vagotomy on cardiovascular response to periodic apneas in sedated pigs

Effects of vagotomy on cardiovascular response to periodic apneas in sedated pigs

Pulmonary artery dilation indicates severe obstructive sleep apnea in patients with resistant hypertension: the Resist-POL Study

Síndrome Das Apnéias / Hipopnéias Obstrutivas Do Sono (Sahos)

Contact Info

Product

Resources

About