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Effect of Treatment by Nasal CPAP onCardiopulmonary Exercise Test in ObstructiveSleep Apnea Syndrome

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Abstract

This study was done to evaluate whether cardiac dysfunction or abnormal measurements on cardiopulmonary exercise testing (CPET) can be improved after 2 months of nasal CPAP treatment. Twenty patients with moderate or severe OSAS received nasal CPAP treatment. All subjects also underwent blood pressure, simple spirometric, and arterial blood gas (ABG) measurements; cardiac evaluation by radionuclide scanning and CPET; and an overnight polysomnography sleep study before and after nasal CPAP treatment. No difference in left ventricular ejection fraction (LVEF) was found after 2 months of nasal CPAP treatment, but higher right ventricular ejection fraction (RVEF), VO2peak, VO2peak/kg and workpeak were observed. After 2 months of nasal CPAP treatment, these patients had a lower breathing reserve and a greater increase in anaerobic threshold and oxygen pulse. Moderate to severe OSAS patients before nasal CPAP treatment had abnormal CPET as reflected by lower RVEF, VO2peak/kg, workpeak, anaerobic threshold and oxygen pulse. These abnormalities can be improved after 2 months of nasal CPAP treatment.

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References

  1. InstitutionalAuthorNameAmerican Academy of Sleep Medicine (1999) ArticleTitleSleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research Sleep 22 667–689

    Google Scholar 

  2. InstitutionalAuthorNameAmerican Thoracic Society (1989) ArticleTitleIndications and standards for cardiopulmonary sleep studies Am Rev Respir Dis 139 559–568

    Google Scholar 

  3. I Astrand PO Astrand A Stunkard (1960) ArticleTitleOxygen intake of obese individuals during work on a bicycle ergometer Acta Physiol Scand 50 294–299 Occurrence Handle1:STN:280:CC%2BD3cvgvFA%3D Occurrence Handle13684885

    CAS  PubMed  Google Scholar 

  4. E Ballester JR Badia L Hernandez et al. (1999) ArticleTitleEvidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome Am J Respir Crit Care Med 159 495–501 Occurrence Handle1:STN:280:DyaK1M7is1Kksg%3D%3D Occurrence Handle9927363

    CAS  PubMed  Google Scholar 

  5. MA Carskadon WC Dement MM Mitler et al. (1986) ArticleTitleGuidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness Sleep 9 519–524 Occurrence Handle1:STN:280:BiiC3MbmvV0%3D Occurrence Handle3809866

    CAS  PubMed  Google Scholar 

  6. KR Cooper BA Philips (1982) ArticleTitleEffect of short-term sleep loss on breathing J Appl Physiol 53 855–858 Occurrence Handle1:STN:280:BiyC3cfksFE%3D Occurrence Handle6818200

    CAS  PubMed  Google Scholar 

  7. RI Dickson A Blokmanis (1987) ArticleTitleTreatment of obstrucive sleep apnea by uvulopalatopharyngoplasty Laryngoscope 97 1054–1059 Occurrence Handle1:STN:280:BiiA3Mvhs1Y%3D Occurrence Handle3626731

    CAS  PubMed  Google Scholar 

  8. EEG Arousals (1992) ArticleTitleScoring rules and examples. A preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association Sleep 15 173–184 Occurrence Handle11032543

    PubMed  Google Scholar 

  9. A el-Manshawi KJ Killian E Summers NL Jones (1986) ArticleTitleBreathlessness during exercise with and without resistive loading J Appl Physio 61 896–905 Occurrence Handle1:STN:280:BiiD3cfhslU%3D

    CAS  Google Scholar 

  10. InstitutionalAuthorNameERS Task Force on Standardization of Clinical Exercise Testing (1997) ArticleTitleClinical exercise testing with reference to lung diseases: indications, standardization, and interpretation strategies Eur Respir J 10 2662–2689

    Google Scholar 

  11. EC Fletcher JW Schaaf J Miller JG Fletcher (1987) ArticleTitleLong-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease Am Rev Respir Dis 135 525–533 Occurrence Handle1:STN:280:BiiC2MvmvF0%3D Occurrence Handle3826878

    CAS  PubMed  Google Scholar 

  12. UC Guidry LA Mendes JC Evans et al. (2001) ArticleTitleEchocardiographic features of the right heart in sleep-disordered breathing: the Framingham Heart Study Am J Respir Crit Care Med 164 933–938 Occurrence Handle1:STN:280:DC%2BD3MrmtF2jsg%3D%3D Occurrence Handle11587973

    CAS  PubMed  Google Scholar 

  13. C Guilleminault A Tilkian WC Dement (1976) ArticleTitleThe sleep apnea syndromes Ann Rev Med 27 465–484 Occurrence Handle10.1146/annurev.me.27.020176.002341 Occurrence Handle1:STN:280:CSmB3s%2FhtlE%3D Occurrence Handle180875

    Article  CAS  PubMed  Google Scholar 

  14. J He MH Kryger FJ Zorick W Conway T Roth (1988) ArticleTitleMortality and apnea index in obstructive sleep apnea—experience in 385 male patients Chest 94 9–14 Occurrence Handle1:STN:280:BieB2MvisV0%3D Occurrence Handle3289839

    CAS  PubMed  Google Scholar 

  15. J Hedner B Darpo H Ejnell J Carlson K Caidahl (1995) ArticleTitleReduction in sympathetic activity after long-term CPAP treatment in sleep apnoea: cardiovascular implications Eur Respir J 8 222–229 Occurrence Handle10.1183/09031936.95.08020222 Occurrence Handle1:STN:280:ByqB2sfjtFY%3D Occurrence Handle7758555

    Article  CAS  PubMed  Google Scholar 

  16. C Jenkinson RJ Davies R Mullins JR Stradling (1999) ArticleTitleComparison of therapeutic and sub therapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized prospective parallel trial Lancet 353 2100–2105 Occurrence Handle10.1016/S0140-6736(98)10532-9 Occurrence Handle1:STN:280:DyaK1MzhtVSltA%3D%3D Occurrence Handle10382693

    Article  CAS  PubMed  Google Scholar 

  17. P Jennum G Wildschiodtz NJ Christensen T Schwartz (1989) ArticleTitleBlood pressure catecholamines and pancreatic polypeptide in obstructive sleep apnea with and without nasal continuous positive airway pressure treatment Am J Hypertens 2 847–852 Occurrence Handle1:STN:280:By%2BD2svivFM%3D Occurrence Handle2686712

    CAS  PubMed  Google Scholar 

  18. Y Kaneko JS Floras K Usui et al. (2003) ArticleTitleCardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea N Engl J Med 348 1233–1241 Occurrence Handle12660387

    PubMed  Google Scholar 

  19. J Krieger D Grucker E Sforza J Chambron D Kurtz (1991) ArticleTitleLeft ventricular ejection fraction in obstructive sleep apnea: effects of long-term treatment with nasal continuous positive airway pressure Chest 100 917–921 Occurrence Handle1:STN:280:By2D3cnnvVc%3D Occurrence Handle1914605

    CAS  PubMed  Google Scholar 

  20. J Krieger E Sforza M Apprill et al. (1989) ArticleTitlePulmonary hypertension, hypoxemia, and hypercapnia in obstructive sleep apnea patients Chest 96 729–737 Occurrence Handle1:STN:280:By%2BD3cvltFU%3D Occurrence Handle2791665

    CAS  PubMed  Google Scholar 

  21. P Langanke T Podszus T Penzel JH Peter P Wichert Particlevon (1993) ArticleTitleEffect of obstructive sleep apnea on preload of the right heart Pneumologie 47 143–146 Occurrence Handle8497467

    PubMed  Google Scholar 

  22. S Malone PP Liu R Holloway et al. (1991) ArticleTitleObstructive sleep apnea in patients with dilated cardiomyopathy: effect of continuous positive airway pressure Lancet 338 1480–1484 Occurrence Handle10.1016/0140-6736(91)92299-H Occurrence Handle1:STN:280:By2D2sblvVA%3D Occurrence Handle1683918

    Article  CAS  PubMed  Google Scholar 

  23. JH Marcus RH Ingram SuffixJr RL McLean (1971) ArticleTitleThe threshold of anaerobic metabolism in chronic obstructive pulmonary disease: a promising index of evaluation Am Rev Respir Dis 104 490–498 Occurrence Handle1:STN:280:CS2D3czgtFw%3D Occurrence Handle5094049

    CAS  PubMed  Google Scholar 

  24. O Marrone V Bellia G Ferrara et al. (1989) ArticleTitleTransmural pressure measurements—importance in the assessment of pulmonary hypertension in obstructive sleep apnea Chest 95 338–342 Occurrence Handle1:STN:280:BiaC38%2FisFQ%3D Occurrence Handle2914485

    CAS  PubMed  Google Scholar 

  25. J Montplaisir MA Bedard F Richer I Rouleau (1992) ArticleTitleNeurobehavioral manifestations in obstructive sleep apnea syndrome before and after treatment with continuous positive airway pressure Sleep 15 S17–S19 Occurrence Handle1:STN:280:ByyC3M%2Fit1Q%3D Occurrence Handle1470802

    CAS  PubMed  Google Scholar 

  26. T Mooe KA Franklin K Holmstrom T Rabben U Wiklund (2001) ArticleTitleSleep-disordered breathing and coronary artery disease: long-term prognosis Am J Respir Crit Care Med 164 1910–1913 Occurrence Handle1:STN:280:DC%2BD3Mnosl2kuw%3D%3D Occurrence Handle11734445

    CAS  PubMed  Google Scholar 

  27. A Naimark RM Cherniack (1960) ArticleTitleCompliance of the respiratory system and its components in health and obesity J Appl Physiol 15 377–382 Occurrence Handle1:STN:280:CC%2BC2sflsVI%3D Occurrence Handle14425845

    CAS  PubMed  Google Scholar 

  28. W Pankow A Lies FW Lohmann (2000) ArticleTitleSleep-disordered breathing and hypertension N Engl J Med 343 966–967 Occurrence Handle10.1056/NEJM200009283431310 Occurrence Handle1:STN:280:DC%2BD3cvmtVSjsA%3D%3D

    Article  CAS  Google Scholar 

  29. CS Ray DY Sue G Bray JE Hansen K Wasserman (1983) ArticleTitleEffect of obesity on respiratory function Am Rev Respir Dis 128 501–506 Occurrence Handle1:STN:280:BiyA3cnotVY%3D Occurrence Handle6614644

    CAS  PubMed  Google Scholar 

  30. Rechtschaffen A, Kales A (1968) A manual of standard terminology techniques and scoring systems for sleep stages of human subjects. Md: National Institutes of Health, Bethesda, MD

  31. S Redline N Adams ME Strauss et al. (1998) ArticleTitleImprovement of mild sleep-disordered breathing with CPAP compared with conservative therapy Am J Respir Crit Care Med 157 858–865 Occurrence Handle1:STN:280:DyaK1c7ns1Orsg%3D%3D Occurrence Handle9517603

    CAS  PubMed  Google Scholar 

  32. RD Ross SR Daniels JM Loggie RA Meyer ET Ballard (1987) ArticleTitleSleep apnea-associated hypertension and reversible left ventricular hypertrophy J Pediatr 111 253–255 Occurrence Handle1:STN:280:BiiB1czgsVQ%3D Occurrence Handle2956404

    CAS  PubMed  Google Scholar 

  33. D Sajkov RJ Cowie AT Thornton HA Espinoza RD McEvoy (1994) ArticleTitlePulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome Am J Respir Crit Care Med 149 416–422 Occurrence Handle1:STN:280:ByuC3sfmtVA%3D Occurrence Handle8306039

    CAS  PubMed  Google Scholar 

  34. E Sforza J Krieger E Weitzenblum et al. (1990) ArticleTitleLong - term effects of treatment with nasal continuous positive airway pressure on daytime lung function and pulmonary hemodynamics in patients with obstructive sleep apnea Am Rev Respir Dis 141 866–870 Occurrence Handle1:STN:280:By%2BB38rksVQ%3D Occurrence Handle2183656

    CAS  PubMed  Google Scholar 

  35. E Shahar CW Whitney S Redline et al. (2001) ArticleTitleSleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study Am J Respir Crit Care Med 163 19–25 Occurrence Handle1:STN:280:DC%2BD3MzgtVygsw%3D%3D Occurrence Handle11208620

    CAS  PubMed  Google Scholar 

  36. T Shiomi C Guilleminault R Stoohs I Schnittger (1991) ArticleTitleLeftward shift of the interventricular septum and pulsus paradoxus in obstructive sleep apnea syndrome Chest 100 894–902 Occurrence Handle1:STN:280:By2D3cnnvVQ%3D Occurrence Handle1914603

    CAS  PubMed  Google Scholar 

  37. Y Takasaki D Orr J Popkin et al. (1989) ArticleTitleEffect of nasal continuous positive airway pressure on sleep apnea in congestive heart failure Am Rev Respir Dis 140 1578–1584 Occurrence Handle1:STN:280:By%2BC3czitlQ%3D Occurrence Handle2690705

    CAS  PubMed  Google Scholar 

  38. A Tal A Leiberman G Margulis S Sofer (1988) ArticleTitleVentricular dysfunction in children with obstructive sleep apnea: radionuclide assessment Pediatr Pulmonol 4 139–143 Occurrence Handle1:STN:280:BieB3sznsl0%3D Occurrence Handle2836784

    CAS  PubMed  Google Scholar 

  39. K Vondra V Brodan A Bass et al. (1981) ArticleTitleEffects of sleep deprivation on the activity of selected metabolic enzymes in skeletal muscle Eur J Appl Physiol Occup Physiol 47 41–46 Occurrence Handle1:CAS:528:DyaL3MXls1Knsr8%3D Occurrence Handle6795038

    CAS  PubMed  Google Scholar 

  40. K Wasserman (1988) ArticleTitleNew concepts in assessing cardiovascular function Circulation 78 1060–1071 Occurrence Handle1:STN:280:BiaD3czkvVw%3D Occurrence Handle3168185

    CAS  PubMed  Google Scholar 

  41. IM Weisman RJ Zeballos (1994) ArticleTitleAn integrated approach to the interpretation of cardiopulmonary exercise testing Clin Chest Med 15 421–445 Occurrence Handle1:STN:280:ByuA2svhtFQ%3D Occurrence Handle8088102

    CAS  PubMed  Google Scholar 

  42. E Weitzenblum J Krieger M Apprill et al. (1988) ArticleTitleDaytime pulmonary hypertension in patients with obstructive sleep apnea syndrome Am Rev Respir Dis 138 345–349 Occurrence Handle1:STN:280:BiaD28%2FntVE%3D Occurrence Handle3143285

    CAS  PubMed  Google Scholar 

  43. BJ Whipp JA Davis (1984) ArticleTitleThe ventilatory stress of exercise in obesity Am Rev Respir Dis 129 IssueIDsuppl S90–S92 Occurrence Handle1:STN:280:BiuC38njtVY%3D Occurrence Handle6696351

    CAS  PubMed  Google Scholar 

  44. DP White NJ Douglas CF Pickett et al. (1983) ArticleTitleSleep deprivation and the control of ventilation Am Rev Respir Dis 128 984–986 Occurrence Handle1:STN:280:BiuD2sjpvFw%3D Occurrence Handle6418047

    CAS  PubMed  Google Scholar 

  45. T Young M Palta J Dempsey et al. (1993) ArticleTitleThe occurrence of sleep-disordered breathing among middle-aged adults N Engl J Med 328 1230–1235 Occurrence Handle10.1056/NEJM199304293281704 Occurrence Handle1:STN:280:ByyB3Mfms1w%3D Occurrence Handle8464434

    Article  CAS  PubMed  Google Scholar 

  46. RJ Zeballos IM Weisman SM Connery (1998) ArticleTitleComparison of pulmonary gas exchange measurements between incremental and constant work exercise above the anaerobic threshold Chest 113 602–611 Occurrence Handle1:STN:280:DyaK1c7nsFGrtw%3D%3D Occurrence Handle9515832

    CAS  PubMed  Google Scholar 

  47. Y Zohar YP Talmi H Frenkel et al. (1992) ArticleTitleCardiac function in obstructive sleep apnea patients following uvulopalatopharyngoplasty Otolaryngol Head Neck Surg 107 390–394 Occurrence Handle1:STN:280:ByyD38nks1M%3D Occurrence Handle1383911

    CAS  PubMed  Google Scholar 

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Acknowledgments

This research was supported by NSC 89-2314-B-195-005.

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Authors and Affiliations

  1. Chest Division, Department of Internal Medicine, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan

    Ching-Chi Lin, Ching-Kai Lin, Kun-Ming Wu & Chon-Shin Chou

  2. Mackay Junior College of Nursing, Taipei, Taiwan

    Ching-Chi Lin

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  1. Ching-Chi Lin
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Correspondence to Ching-Chi Lin.

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Lin, CC., Lin, CK., Wu, KM. et al. Effect of Treatment by Nasal CPAP onCardiopulmonary Exercise Test in ObstructiveSleep Apnea Syndrome. Lung 182, 199–212 (2004). https://doi.org/10.1007/s00408-004-2502-7

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