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Titolo:
REDUCTION IN SYMPATHETIC ACTIVITY AFTER LONG-TERM CPAP TREATMENT IN SLEEP-APNEA - CARDIOVASCULAR IMPLICATIONS
Autore:
HEDNER J; DARPO B; EJNELL H; CARLSON J; CAIDAHL K;
Indirizzi:
SAHLGRENS UNIV HOSP,DEPT CLIN PHARMACOL S-41345 GOTHENBURG SWEDEN SAHLGRENS UNIV HOSP,DEPT CARDIOL S-41345 GOTHENBURG SWEDEN SAHLGRENS UNIV HOSP,DEPT OTORHINOLARYNGOL S-41345 GOTHENBURG SWEDEN SAHLGRENS UNIV HOSP,DEPT CLIN PHYSIOL S-41345 GOTHENBURG SWEDEN RENSTROMSKA HOSP,DEPT PULM MED GOTHENBURG SWEDEN
Titolo Testata:
The European respiratory journal
fascicolo: 2, volume: 8, anno: 1995,
pagine: 222 - 229
SICI:
0903-1936(1995)8:2<222:RISAAL>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
MUSCLE NERVE ACTIVITY; APNEA SYNDROME; BLOOD-PRESSURE; ESSENTIAL-HYPERTENSION; ARTERIAL-PRESSURE; RISK-FACTORS; NASAL CPAP; CATECHOLAMINES; MEN; DETERMINANTS;
Keywords:
CARDIAC STRUCTURE; HYPERTENSION; NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE; NOREPINEPHRINE; SLEEP APNEA SYNDROME; SYMPATHETIC ACTIVITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
48
Recensione:
Indirizzi per estratti:
Citazione:
J. Hedner et al., "REDUCTION IN SYMPATHETIC ACTIVITY AFTER LONG-TERM CPAP TREATMENT IN SLEEP-APNEA - CARDIOVASCULAR IMPLICATIONS", The European respiratory journal, 8(2), 1995, pp. 222-229

Abstract

Twelve patients with severe obstructive sleep apnoea were included inan open, long-term, prospective, follow-up study addressing the effects of nasal continuous positive airway pressure (CPAP) on sympathetic activity, cardiac structure and blood pressure. Plasma norepinephrine (P-NE) (daytime at rest), daytime and night-time urinary excretion of NE (U-NE), vanylmandelic acid and metanephrines, together with 24 h noninvasive blood pressure (BP) recording and Doppler-echocardiography, were assessed before and after a mean of 20.5 (range 14-26) months of CPAP. Average self-reported use of CPAP was 89% (range 65-100%) of time spent in bed. Resting daytime P-NE ranged 0.35-0.83 ng . ml(-1), which is elevated compared to healthy controls. Only night-time U-NE, mean daytime BP and average 24 h BP were related to severity of OSA. Night-time metanephrine was related to daytime and night-time diastolic, as well as night-time systolic, BP. Left ventricular mass index (LVMI) at baseline was correlated to daytime systolic BP and P-NE. Longterm CPAP treatment reduced biochemical markers of sympathetic activity. P-NE decreased by approximately 50%, and daytime and night-time vanylmandelic acid and metanephrine by 32-54%. In contrast, there were no overall reductions in BP or LVMI. It is concluded that obstructive sleep apnoea is associated with high sympathetic activity both during sleep and waking periods. Urinary metanephrine excretion seemed to reflect blood pressure, but neither daytime nor night-time catecholamine excretion was directly related to disease severity in patients with severe obstructive sleep apnoea. In spite of a marked reduction of catecholamineexcretion at followup, BP and cardiac structure remained unchanged. Although increased sympathetic activity may act as a contributory trigger for cardiovascular disease in sleep apnoea, a reduction of activityafter nasal CPAP is not associated with changes in blood pressure or cardiac structure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/10/20 alle ore 00:05:27