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Titolo:
AUTONOMIC CARDIAC REGULATION IN OBSTRUCTIVE SLEEP-APNEA SYNDROME - EVIDENCE FROM SPONTANEOUS BAROREFLEX ANALYSIS DURING SLEEP
Autore:
PARATI G; DIRIENZO M; BONSIGNORE MR; INSALACO G; MARRONE O; CASTIGLIONI P; BONSIGNORE G; MANCIA G;
Indirizzi:
OSPED SAN LUCA,VIA SPAGNOLETTO 3 I-20149 MILAN ITALY UNIV PALERMO,CNR,OSPED S GERARDO,IST FISIOPATOL RESP MONZA ITALY UNIV MILAN,CTR FISIOL CLIN & IPERTENS MILAN ITALY IRCCS,OSPED MAGGIORE MILAN ITALY UNIV MILAN,IST AUXOL ITALIANO,IST SCI,OSPED S LUCA MILAN ITALY ISTSAF MILAN ITALY FDN PRO JUVENTUTE,CTR BIOINGN,LARC MILAN ITALY
Titolo Testata:
Journal of hypertension
fascicolo: 12, volume: 15, anno: 1997,
parte:, 2
pagine: 1621 - 1626
SICI:
0263-6352(1997)15:12<1621:ACRIOS>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-PRESSURE; CONDUCTION DISTURBANCES; HYPERTENSION; SENSITIVITY; TRACHEOSTOMY; ARRHYTHMIAS; MECHANISMS; PREVALENCE;
Keywords:
OBSTRUCTIVE SLEEP APNEA; BAROREFLEX SENSITIVITY; BLOOD PRESSURE; SEQUENCE TECHNIQUE; HYPERTENSION; SYMPATHETIC NERVOUS SYSTEM;
Tipo documento:
Article
Natura:
Periodico
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
G. Parati et al., "AUTONOMIC CARDIAC REGULATION IN OBSTRUCTIVE SLEEP-APNEA SYNDROME - EVIDENCE FROM SPONTANEOUS BAROREFLEX ANALYSIS DURING SLEEP", Journal of hypertension, 15(12), 1997, pp. 1621-1626

Abstract

Objective To assess spontaneous baroreceptor-heart rate reflex sensitivity during sleep in patients with obstructive sleep apnea syndrome, a condition associated with increased cardiovascular morbidity and mortality and characterized by marked sympathetic activation, which is believed to originate from hypoxic chemoreceptor stimulation, although little is known of other possible mechanisms such as baroreflex impairment. Design and methods In 11 patients with severe obstructive sleep apnea syndrome (mean +/- SD age 46.8 +/- 8.1 years, apnea/hypopnea index 67.9 +/- 19.1 h), who were normotensive or borderline hypertensive during wakefulness by clinic blood pressure measurements, finger blood pressure was monitored beat-by-beat non-invasively (Finapres) at nightduring polysomnography. Periods of wakefulness and sleep were identified based on electroencephalographic recordings. Baroreflex sensitivity was assessed by the sequence technique, as the slope of the regression line between spontaneous increases or reductions in systolic blood pressure (SBP) and the related lengthening or shortening in the RR interval, occurring over spontaneous sequences of four or more consecutive beats. The number of these sequences was also computed, as an additional index of baroreflex engagement by the spontaneous blood pressure fluctuations. The controls were age-related normotensive or borderlinehypertensive subjects without sleep apnea who had been investigated in previous studies; in these subjects blood pressure was recorded intra-arterially over 24 h in ambulatory conditions and spontaneous baroreflex sensitivity was assessed by the sequence technique. Results In our patients the lowest nocturnal arterial oxygen saturation was 78.6 +/- 12.1% (mean +/- SD). During sleep, the number of pooled +RR/+SBP and-RR/-SBP sequences per hour was 20.3 +/- 2.7 per h in patients with sleep apnea and 27.1 +/- 2.1/h in controls (means SEM). The average baroreflex sensitivity during sleep periods was 7.04 +/- 0.8 ms/mmHg in sleep apnea patients and 10.05 +/- 2.1 ms/mmHg in controls. Both the pooled number of sequences and baroreflex sensitivity values of the sleep apnea patients were significantly (P < 0.01) less than the corresponding night values of control subjects. In the sleep apnea patients, atvariance from controls, baroreflex sensitivity did not show any increase during sleep compared with its values during wakefulness (6.9 +/- 1.0 ms/mmHg). Conclusions Our data provide evidence that spontaneous baroceptor reflex sensitivity is depressed in severe obstructive sleep apnea syndrome. This suggests that in such patients baroreflex dysfunction and not only chemoreceptor stimulation by hypoxia may be involvedin the sympathetic activation which occurs during sleep. Such dysfunction may contribute to the higher rate of cardiovascular morbidity andmortality reported in these patients. (C) Rapid Science Publishers ISSN 0263-6352.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 10:15:20