Journal
RESPIROLOGY
Volume 21, Issue 6, Pages 1126-1133Publisher
WILEY
DOI: 10.1111/resp.12798
Keywords
cardiovascular consequences; continuous positive airway pressure; microvascular endothelial function; myocardial perfusion; obstructive sleep apnoea
Categories
Ask authors/readers for more resources
Background and objectiveObstructive sleep apnoea (OSA) is highly prevalent and associated with an increased incidence of cardiovascular events. Endothelial dysfunction is the proposed causative mechanism. Continuous positive airway pressure (CPAP) is presumed to improve cardiovascular outcome in OSA. CPAP withdrawal was recently shown to lead to peripheral endothelial dysfunction. However, it is not known whether short-term CPAP withdrawal reduces myocardial perfusion in OSA. MethodsIn this double-blind randomized controlled study, 45 patients with moderate to severe OSA previously adherent to CPAP were assigned to either subtherapeutic or continuing therapeutic CPAP for 2weeks. The primary outcome was adenosine-induced myocardial blood flow (MBF) as a measure of endothelial function, assessed by N-13-ammonia positron emission tomography. Secondary outcomes were measures of dermal and renal microvascular function, morning blood pressure (BP) and heart rate. ResultsDespite return of OSA associated with significant increases in BP (+9.1mmHg, 95% CI +4.9 to +13.4mmHg, P<0.001) and heart rate (+9.6bpm, 95% confidence interval (CI) +4.6 to +14.6bpm, P<0.001), CPAP withdrawal had no significant effect on maximal myocardial perfusion capacity (hyperaemic MBF -0.01ml/min/g, 95% CI -0.33 to +0.24ml/min/g, P=0.91), nor renal and dermal microvascular function. ConclusionIn patients with OSA, a short-term CPAP withdrawal does not lead to detectable impairment of coronary endothelial function, as has been demonstrated in the brachial artery, despite a clinically relevant increase in BP of nearly 10mmHg. There was also no evidence of an impairment of renal or dermal microvascular function.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available