Document Detail

The effect of simulated obstructive apnea and hypopnea on aortic diameter and blood pressure.
MedLine Citation:
PMID:  21393398     Owner:  NLM     Status:  Publisher    
Abstract BACKGROUND: Preliminary evidence supports an association between obstructive sleep apnea (OSA) and thoracic aortic dilatation. The mechanisms through which OSA may promote thoracic aortic dilatation are incompletely understood. Therefore, we studied the acute effects of simulated apnea and hypopnea on aortic diameter and blood pressure in humans. METHODS: In 20 healthy volunteers the diameter of the aortic root was measured by echocardiography and peripheral blood pressure was continuously recorded prior, during and immediately after simulated obstructive hypopnea (inspiration through threshold load), simulated obstructive apnea (Mueller maneuver), end-expiratory central apnea and normal breathing in randomized order. RESULTS: Proximal aortic diameter increased significantly during inspiration through a threshold load (+6.48% (SE3.03), p=0.007), but not during Mueller maneuver (+3.86% (SE2.71), p=0.336) or end-expiratory central apnea (+0.62% (SE 2.94), p=0.445). Maneuver-induced changes in mean blood pressure were observed during inspiration through a threshold load (-10.5 (SE2.2) mmHg, p<0.001), the Mueller maneuver (-8.8 (SE2.4) mmHg, p<0.001), and end-expiratory central apnea (-4.2 (SE1.4) mmHg, p=0.052). There was a significant increase in mean blood pressure on release of threshold load inspiration (+8.1 (SE2.9) mmHg, p=0.002), Mueller maneuver (+10.7 (SE2.9) mmHg, p<0.001) and end-expiratory central apnea (+10.6 (SE2.5) mmHg, p<0.001). CONCLUSION: Simulated obstructive hypopnea/apnea and central apnea induced considerable changes in blood pressure and obstructive hypopnea was associated with an increase in proximal aortic diameter. Further studies are needed to investigate effects of apnea and hypopnea on transmural aortic pressure and aortic diameter in order to define the role of OSA in the pathogenesis of aortic dilatation.
Anne-Christin Stöwhas; Mehdi Namdar; Patric Biaggi; Erich W Russi; Konrad E Bloch; John R Stradling; Malcolm Kohler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-10
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Switzerland.
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