Unique cardiopulmonary exercise test responses in overweight middle-aged adults with obstructive sleep apnea

Kaleth, Anthony S.; Chittenden, Thomas; Hawkins, Brian T.; Hargens, Trent A.; Guill, Steve G.; Zedalis, Donald; Gregg, John M.; Herbert, William G.

doi:10.1016/j.sleep.2006.08.005

Cited by 67 publications

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“…(15,18) We can speculate that this correlation might be an initial presentation of the systemic arterial hypertension that develops in patients with nocturnal oxygen desaturation, since the autonomic dysfunction in blood pressure control, due to upregulation of the baroreflex controlled by carotid bodies, has been well established in experimental models and clinical studies of OSAS. (11) Oxidative stress is certainly a factor related to intermittent hypoxemia.…”

Section: Resultsmentioning

confidence: 95%

“…Some studies have revealed no reduction in aerobic capacity on the cycle ergometer test, (12,13) whereas others have reported a significant reduction. (14,15) One study showed a significant increase in VO 2 max after the use of noninvasive support ventilation. (25) However, in those studies, would allow exploratory associative analyses among the principal variables of interest.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have found reduced exercise capacity in patients with OSAS, (12,13) although others have demonstrated no such impairment. (14,15) It is also known that increases in the levels of C-reactive protein (CRP), platelets, fibrinogen, and interleukin-6 are associated with nocturnal hypoxemia in patients with OSAS, (16) together with altered autonomic tone, (11) altered daytime catecholaminergic activity, (17) and increased diastolic blood pressure (DBP) during maximal exercise. (18) Our objective in this study was to evaluate the impact of nocturnal oxygen desaturation on maximal aerobic capacity and on its hemodynamic alteration components, as well as to determine maximal respiratory pressures, maximal voluntary isometric contraction (MVIC) force, and comparative CRP levels in patients with COPD, presenting normoxemia or mild hypoxemia during the day, with and without nocturnal oxygen desaturation.…”

Section: Introductionmentioning

confidence: 99%

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Efeitos sistêmicos da hipoxemia noturna em pacientes com doença pulmonar obstrutiva crônica sem síndrome da apnéia obstrutiva do sono

et al. 2008

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Objective: To study the effects of nocturnal hypoxemia in patients with chronic obstructive pulmonary disease without obstructive sleep apnea syndrome. Methods: We studied 21 patients-10 desaturators and 11 nondesaturators-submitted to arterial blood gas analysis, polysomnography, spirometry, cardiopulmonary exercise testing (cycle ergometer), and hand-grip dynamometry, as well as measurements of maximal inspiratory pressure, maximal expiratory pressure, and C-reactive protein (CRP) levels. Patients with arterial oxygen tension > 60 mmHg were included; those with an apnea-hypopnea index > 5 events/hour of sleep were excluded. Maximal oxygen uptake, maximal power, systolic blood pressure, diastolic blood pressure (DBP), and maximal heart rate were measured during exercise in order to detect hemodynamic alterations. Patients presenting CRP levels above 3 mg/L were considered CRP-positive. Results: Minimum peripheral oxygen saturation during sleep was significantly higher among nondesaturators (p = 0.03). More desaturators presented CRP > 3 mg/L (p < 0.05). No differences were observed in terms of any variables. However, mean oxygen saturation during sleep correlated with DBP and maximal inspiratory pressure (p < 0.001 and p = 0.001, respectively). Conclusions: Although nocturnal hypoxemia does not reduce exercise capacity or hand-grip strength in patients with mild/moderate COPD, its effect on maximal exercise DBP seems to depend on the degree of hypoxemia. In addition, there is a positive relationship between maximal inspiratory pressure and mean oxygen saturation during sleep, as well as evidence of pronounced inflammatory activation in patients with nocturnal hypoxemia.Keywords: Pulmonary disease, chronic obstructive; Exercise test; Anoxia; Respiratory function tests. ResumoObjetivo: Estudar os efeitos da hipoxemia noturna em pacientes com doença pulmonar obstrutiva crônica sem síndrome da apnéia obstrutiva do sono. Métodos: Estudamos 21 pacientes-10 dessaturadores e 11 não-dessaturadores-submetidos a gasometria arterial, polissonografia, espirometria, teste de exercício cardiopulmonar (cicloergômetro), dinamometria manual e medidas de pressão inspiratória máxima, pressão expiratória máxima e proteína C reativa (PCR). Incluíram-se os pacientes com pressão parcial arterial de oxigênio > 60 mmHg; excluíram-se os com índice de apnéia-hipopnéia > 5 eventos/hora de sono. Foram medidos consumo máximo de oxigênio, potência máxima, pressão arterial sistólica, pressão arterial diastólica (PAD) e frequência cardíaca máxima durante exercício, visando detectar alterações hemodinâmicas. A PCR foi considerada positiva quando acima de 3 mg/L. Resultados: A saturação periférica de oxigênio mínima durante o sono foi significativamente maior nos não-dessaturadores (p = 0,03). Mais dessaturadores apresentaram PCR > 3 mg/L (p < 0,05). Não houve diferença quanto a capacidade de exercício e demais variáveis. No entanto, PAD (p < 0,001) e pressão inspiratória máxima (p = 0,001) correlacionaram-se com saturação periférica de o...

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Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efeitos sistêmicos da hipoxemia noturna em pacientes com doença pulmonar obstrutiva crônica sem síndrome da apnéia obstrutiva do sono

et al. 2008

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“…The impact of obstructi sleep apnoea (OSA) on exercise capacity remains unclear, given some studies have shown that this disorder reduces exercise capacity (2 others have found no differences in exercise capacity between OSA and non-OSA populations (7 Several factors impact aerobic capacity, as measured by cardiopulmonary exercise testing (CPET). Severe obesity reduces exercise capacity because fat mass interferes with cardiac and respiratory function (13).…”

Section: Introductionmentioning

confidence: 99%

“…A person's sex also has an influence on exercise capacity, which could be at least 20%-40% lower in women than in men (15). These variables have not always been considered, however, when interpreting the results of studies that have evaluated exercise capacity in patients with OSA (2)(3)(4)(5)(6)(7)(8)(9)(10)12). Moreover, these reports have included only a small number of women; therefore, their results might not extend to this population.…”

Section: Introductionmentioning

confidence: 99%

Exercise capacity and heart rate recovery response to exercise in morbidly obese female patients with obstructive sleep apnoea syndrome.

et al. 2017

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INTRODUCTION:To study exercise capacity and heart rate (HR) recovery after peak exercise in morbidly obese female patients with obstructive sleep apnoea (OSA). METHODS:Twenty-four morbidly obese female patients (36.17 ± 9.20 years and 45.20 ± 5.41 kg.m diagnosed with OSA underwent cardiopulmonary exercise testing (CPET) for assessment of peak oxygen uptake (V'O2) and heart rate (HR) recovery at 30, 60 a index [AHI] <15 h-1) and moderate-to-severe (AHI RESULTS: For the entire study population, peak V'O2 was 15.58 ± 2.44 ml.min were found between moderate-to-severe and mild OSA (16.11 ± 2.37 vs. 15.19 ± 2.50 ml.min respectively). HR recovery registered at any time after the peak workload also did not differ between both groups. Nonetheless, the percentage of HR decrease at 90 seconds in the patients with moderate-to-severe OSA (p=.073), and it was negatively correlated with the oxygen desaturation index (r =-0.679, p=.044). CONCLUSION:Exercise capacity is not different bet Nevertheless, patients with moderatethose with milder OSA. Finally, the oxygen desaturation index is related to this slower chron Keywords: Obstructive sleep apnoea, Exercise test, Female, Heart rate, Obesity. Received March 20, 2017; Accepted May 11, 2017 Copyright: © 2017 Authors. This is an open License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and sourc credited. Editor: Javier Jareño Cite as: Carpio C., Santiago A., Gómez-Mendieta M., Caballero P., Martín capacity and heart rate recovery response to exercise in morbidly obese female patients with obstructive sleep apnoea syndrom IBJ Plus 2017 1(1):e0004. Funding: The author(s) declared that no grants were involved in supporting this work. To study exercise capacity and heart rate (HR) recovery after peak exercise in morbidly obese female patients with obstructive sleep apnoea (OSA).four morbidly obese female patients (36.17 ± 9.20 years and 45.20 ± 5.41 kg.m diagnosed with OSA underwent cardiopulmonary exercise testing (CPET) for assessment of peak oxygen uptake (V'O2) and heart rate (HR) recovery at 30, 60 and 90 seconds. Comparisons were made between mild (apnoea severe (AHI ≥15 h-1) OSA.For the entire study population, peak V'O2 was 15.58 ± 2.44 ml.min-1.kg-1. No differences in peak V'O2 severe and mild OSA (16.11 ± 2.37 vs. 15.19 ± 2.50 ml.min respectively). HR recovery registered at any time after the peak workload also did not differ between both groups. Nonetheless, the percentage of HR decrease at 90 seconds of recovery time was almost statistically significantly lower severe OSA (p=.073), and it was negatively correlated with the oxygen desaturation Exercise capacity is not different between patients with mild and moderate -to-severe OSA tend to have a slower HR recovery response to exercise than those with milder OSA. Finally, the oxygen desaturation index is related to this slower chronotropic response.Obstructive sleep apnoea, Exercise test, Female, Heart rate, Obesity.May 11, 2017; Published May 23, 2017...

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Heart Rate Recovery and Oxygen Kinetics After Exercise in Obstructive Sleep Apnea Syndrome

Nanas

Sakellariou

Kapsimalakou

et al. 2010

Clinical Cardiology

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Background: Patients who suffer from obstructive sleep apnea (OSA) have a decreased exercise capacity and abnormal autonomic nervous function. However, the kinetics of early oxygen (O 2 ) and heart rate recovery (HRR) have not been described. Materials and Methods:We evaluated 21 men with moderate to severe OSA (mean age: 48 ± 11 yrs, mean apnea-hypopnea index [AHI]: 55 ± 13) and without known heart disease and 10 healthy men matched for age and body mass index (BMI; controls). Men with OSA underwent overnight polysomnography, and both groups underwent symptom-limited incremental cardiopulmonary exercise testing (CPET). We recorded the CPET parameters including peak O 2 uptake (VO 2 p), kinetics of early O 2 recovery by the first degree slope of VO 2 during the first minute (VO 2 /t slope), the time required for a 50% decline of VO 2 p during recovery (T 1/2 ), and early heart rate recovery (HRR = HR at maximal exercise − HR at 1 min of recovery), as well as the chronotropic reserve to exercise ([CR] = [peak HR − resting HR/220 − age − resting HR] × 100). Patients with OSA had a lower VO 2 p (28.7 ± 4.0 vs 34.7 ± 6.2 mL/kg/min), VO 2 /t slope (1.04 ± 0.3 vs 1.4 ± 0.17 mL/kg/min 2 ), and T 1/2 (74 ± 10 vs 56 ± 6 sec) compared to controls (all P < 0.001). In addition, both HRR and CR were lower in the OSA group (22.0 ± 7.0 vs 31.0 ± 6.0 bpm,P:0.003, and 79.0% ± 15% vs 99.0% ± 13.0%, P:0.01, respectively). Conclusions: Patients with OSA demonstrate reduced exercise capacity, delayed oxygen kinetics, and reduced HRR. These data point to abnormal oxygen delivery and/or oxidative function of the peripheral muscles and impaired autonomic nervous activity in OSA patients.

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Unique cardiopulmonary exercise test responses in overweight middle-aged adults with obstructive sleep apnea

Cited by 67 publications

References 68 publications

Efeitos sistêmicos da hipoxemia noturna em pacientes com doença pulmonar obstrutiva crônica sem síndrome da apnéia obstrutiva do sono

Efeitos sistêmicos da hipoxemia noturna em pacientes com doença pulmonar obstrutiva crônica sem síndrome da apnéia obstrutiva do sono

Exercise capacity and heart rate recovery response to exercise in morbidly obese female patients with obstructive sleep apnoea syndrome.

Heart Rate Recovery and Oxygen Kinetics After Exercise in Obstructive Sleep Apnea Syndrome

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