Document Detail


Changes in left and right ventricular mechanics during the Mueller maneuver in healthy adults: a possible mechanism for abnormal cardiac function in patients with obstructive sleep apnea.
MedLine Citation:
PMID:  20160141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Obstructive sleep apnea is highly prevalent in patients with cardiovascular disease and has detrimental effects on systolic and diastolic function of the ventricles. In this research, the changes in strain (S) and strain rate (SR) during the performance of the Mueller maneuver (MM) in an effort to better understand how negative intrathoracic pressures affect ventricular mechanics.
METHODS AND RESULTS: The MM was performed to maintain a target intrathoracic pressure of -40 mm Hg. Echocardiography was used to measure various parameters of cardiac structure and function. Myocardial deformation measurements were performed using tissue speckle tracking. Twenty-four healthy subjects (9 women; mean age, 30+/-6 years) were studied. Global left ventricular longitudinal S in systole and SR in early filling were significantly decreased during the MM (S: baseline, -17.0+/-1.6%; MM, -14.5+/-2.2%; P<0.0001, SR: baseline, 1.09+/-0.20 s(-1); MM, 0.92+/-0.21 s(-1); P=0.01). Global right ventricular longitudinal S was also significantly decreased during the MM (baseline, -22.0+/-3.1%; MM, -17.2+/-2.5%; P<0.0001), as was global right ventricular longitudinal systolic SR (baseline, -1.34+/-0.35 s(-1); MM, -1.02+/-0.21 s(-1); P=0.0006).
CONCLUSIONS: Left ventricular and right ventricular longitudinal deformation are significantly reduced during the MM. These results suggest that negative intrathoracic pressure during apnea may contribute to changes in myocardial mechanics. These results could help explain the observed changes in left ventricular and right ventricular mechanics in patients with obstructive sleep apnea.
Authors:
Yuki Koshino; Hector R Villarraga; Marek Orban; Charles J Bruce; Gregg S Pressman; Pavel Leinveber; Haydar K Saleh; Tomas Konecny; Tomas Kara; Virend K Somers; Francisco Lopez-Jimenez
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-16
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-06-17     Revised Date:  2011-05-13    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Echocardiography, Doppler / methods
Female
Heart Ventricles / ultrasonography*
Humans
Image Processing, Computer-Assisted / methods
Male
Observer Variation
Oxygen Consumption*
Sleep Apnea, Obstructive*
Ventricular Dysfunction, Left / ultrasonography*
Ventricular Dysfunction, Right / ultrasonography*
Grant Support
ID/Acronym/Agency:
UL1 RR024150-04S2/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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