Document Detail


Effects of CPAP therapy on the sympathovagal balance and arterial stiffness in obstructive sleep apnea.
MedLine Citation:
PMID:  20138492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Increased arterial stiffness and sympathovagal imbalance are noted in patients with obstructive sleep apnea (OSA). It has been thought that continuous positive airway pressure (CPAP) therapy can have beneficial effects on the vascular function in such cases. However, it is not yet clear whether the improvement of sympathovagal balance by CPAP might be related to reduction of the arterial stiffness, independent of changes in the blood pressure. METHODS: In 50 consecutive eligible patients with OSA (apnea-hypopnea index>/=20/hour) receiving CPAP therapy, the brachial-ankle pulse wave velocity (baPWV), heart rate variability (LF, HF and LF/HF ratio), baroreceptor sensitivity (BRS), plasma levels of C-reactive protein (CRP), and endothelial function as assessed by changes in the forearm blood flow before and after reactive hyperemia (END) were measured before and after 3-months' CPAP therapy. RESULTS: Significant decrease of the LF/HF ratio, plasma levels of CRP, baPWV and heart rate were observed after 3 months' CPAP therapy. The change in the baPWV following 3-months' CPAP therapy was significantly correlated with the change in the LF/HF ratio and mean blood pressure (MBP), but not with that of the BRS, CRP or END after the therapy. Multivariate linear regression analysis demonstrated a significant correlation between the change in the LF/HF ratio and that in the baPWV (beta=0.305, p=0.041), independent of the changes in the MBP, plasma CRP levels and heart rate. CONCLUSIONS: Improvement of the sympathovagal balance by CPAP therapy may be significantly related to decreased stiffness of the central to middle-sized arteries, independent of the changes in the blood pressure and vascular endothelial status.
Authors:
Kazuki Shiina; Hirofumi Tomiyama; Yoshifumi Takata; Masanobu Yoshida; Kota Kato; Hirokazu Saruhara; Yuki Hashimura; Chisa Matsumoto; Kihiro Asano; Yasuhiro Usui; Akira Yamashina
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2010-02-06
Journal Detail:
Title:  Respiratory medicine     Volume:  104     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  911-6     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
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MeSH Terms
Descriptor/Qualifier:
Arteries / physiopathology*
Blood Pressure / physiology
Continuous Positive Airway Pressure / methods*
Elasticity / physiology*
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Polysomnography
Sleep Apnea, Obstructive / physiopathology*,  therapy
Treatment Outcome
Vascular Resistance / physiology*

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


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