Impact of Continuous Positive Airway Pressure on Left Ventricular Systolic Loading and Coronary Flow Reserve in Healthy Young Men
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Impact of Continuous Positive Airway Pressure on Left Ventricular Systolic Loading and Coronary Flow Reserve in Healthy Young Men. / Schulze, Volker; Meyer, Christian; Eickholt, Christian; Sansone, Roberto; Keymel, Stefanie; Heiss, Christian; Rassaf, Tienush; Kelm, Malte; Steiner, Stephan.
In: HEART LUNG CIRC, Vol. 27, No. 3, 03.2018, p. 344-349.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of Continuous Positive Airway Pressure on Left Ventricular Systolic Loading and Coronary Flow Reserve in Healthy Young Men
AU - Schulze, Volker
AU - Meyer, Christian
AU - Eickholt, Christian
AU - Sansone, Roberto
AU - Keymel, Stefanie
AU - Heiss, Christian
AU - Rassaf, Tienush
AU - Kelm, Malte
AU - Steiner, Stephan
N1 - Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
PY - 2018/3
Y1 - 2018/3
N2 - BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve.METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery. In a subset of seven individuals, haemodynamic parameters and autonomic function were additionally examined using combined impedance cardiography and continuous noninvasive blood pressure monitoring.RESULTS: Continuous positive airway pressure reduced heart rate corrected (AIx@75) (-2.8±8.1 [rest] to -10.7±11.3 [5mbar], p<0.01, to -12.2±10.5% [10mbar], p<0.01) and systolic time integral as a marker of left ventricular workload (2115±231 [rest] to 1978±290 [5mbar], p=0.02 to 1940±218 [10mbar], p<0.01 to 2013±241mmHg/s per min [recovery], p=0.03), while central systolic pressure did not change during CPAP. Total Peripheral Resistance Index increased reaching level of significance at 10mbar CPAP condition (1701±300 [rest] to 1850±301dyn*s*m2/cm5 [10mbar], p=0.04). There was a reversible increase of SEVR under CPAP conditions.CONCLUSIONS: Continuous positive airway pressure ventilation acutely reduces AIx, heart rate and left ventricular workload in healthy young men. These effects seem to be mediated by left ventricular filling pressure, workload and reflection wave. Furthermore, we found an increase of subendocardial viability ratio as an indication for a rising coronary flow reserve by CPAP.
AB - BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve.METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery. In a subset of seven individuals, haemodynamic parameters and autonomic function were additionally examined using combined impedance cardiography and continuous noninvasive blood pressure monitoring.RESULTS: Continuous positive airway pressure reduced heart rate corrected (AIx@75) (-2.8±8.1 [rest] to -10.7±11.3 [5mbar], p<0.01, to -12.2±10.5% [10mbar], p<0.01) and systolic time integral as a marker of left ventricular workload (2115±231 [rest] to 1978±290 [5mbar], p=0.02 to 1940±218 [10mbar], p<0.01 to 2013±241mmHg/s per min [recovery], p=0.03), while central systolic pressure did not change during CPAP. Total Peripheral Resistance Index increased reaching level of significance at 10mbar CPAP condition (1701±300 [rest] to 1850±301dyn*s*m2/cm5 [10mbar], p=0.04). There was a reversible increase of SEVR under CPAP conditions.CONCLUSIONS: Continuous positive airway pressure ventilation acutely reduces AIx, heart rate and left ventricular workload in healthy young men. These effects seem to be mediated by left ventricular filling pressure, workload and reflection wave. Furthermore, we found an increase of subendocardial viability ratio as an indication for a rising coronary flow reserve by CPAP.
KW - Adult
KW - Blood Pressure/physiology
KW - Continuous Positive Airway Pressure/methods
KW - Coronary Circulation/physiology
KW - Healthy Volunteers
KW - Humans
KW - Male
KW - Pulse Wave Analysis/methods
KW - Stroke Volume/physiology
KW - Systole
KW - Vascular Stiffness/physiology
KW - Ventricular Function, Left/physiology
U2 - 10.1016/j.hlc.2017.02.022
DO - 10.1016/j.hlc.2017.02.022
M3 - SCORING: Journal article
C2 - 28522275
VL - 27
SP - 344
EP - 349
JO - HEART LUNG CIRC
JF - HEART LUNG CIRC
SN - 1443-9506
IS - 3
ER -
