Kim Jonathan H, Hollowed Casey, Irwin-Weyant Morgan, Patel Keyur, Hosny Kareem, Aida Hiroshi, Gowani Zaina, Sher Salman, Gleason Patrick, Shoop James L, Galante Angelo, Clark Craig, Ko Yi-An, Quyyumi Arshed A, Collop Nancy A, Baggish Aaron L
Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia.
Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia.
Am J Cardiol. 2017 Oct 15;120(8):1410-1415. doi: 10.1016/j.amjcard.2017.07.030. Epub 2017 Jul 25.
This study sought to determine the cardiovascular physiologic correlates of sleep-disordered breathing (SDB) in American-style football (ASF) participants using echocardiography, vascular applanation tonometry, and peripheral arterial tonometry. Forty collegiate ASF participants were analyzed at pre- and postseason time points with echocardiography and vascular applanation tonometry. WatchPAT (inclusive of peripheral arterial tonometry) used to assess for SDB was then performed at the postseason time point. Twenty-two of 40 (55%) ASF participants demonstrated SDB with an apnea-hypopnea index (pAHI) ≥5. ASF participants with SDB were larger (109 ± 20 vs 92 ± 14 kg, p = 0.004) and more likely linemen position players (83% vs 50%, p = 0.03). Compared with those without SDB, ASF participants with SDB demonstrated relative impairments in left ventricular diastolic and vascular function as reflected by lower lateral e' (14 ± 3 vs 17 ± 3 cm/s, p = 0.007) and septal e' (11 ± 2 vs 13 ± 2 cm/s, p = 0.009) tissue velocities and higher pulse wave velocity (5.4 ± 0.9 vs 4.8 ± 0.5 m/s, p = 0.02). In the total cohort, there were significant positive correlations between pAHI and pulse wave velocity (r = 0.42, p = 0.008) and inverse correlations between pAHI and the averaged e' tissue velocities (r = -0.42, p = 0.01). In conclusion, SDB is highly prevalent in youthful collegiate ASF participants and associated with relative impairments in cardiac and vascular function. Targeted efforts to identify youthful populations with SDB, including ASF participants, and implement SDB treatment algorithms, represent important future clinical directives.
本研究旨在利用超声心动图、血管压平眼压测量法和外周动脉张力测量法,确定美式橄榄球(ASF)参与者睡眠呼吸障碍(SDB)的心血管生理相关性。对40名大学ASF参与者在赛季前和赛季后的时间点进行了超声心动图和血管压平眼压测量分析。然后在赛季后时间点使用WatchPAT(包括外周动脉张力测量)评估SDB。40名ASF参与者中有22名(55%)表现出呼吸暂停低通气指数(pAHI)≥5的SDB。患有SDB的ASF参与者体型更大(109±20 vs 92±14 kg,p = 0.004),且更有可能是前锋位置球员(83% vs 50%,p = 0.03)。与无SDB者相比,患有SDB的ASF参与者在左心室舒张和血管功能方面表现出相对损伤,表现为较低的侧壁e'(14±3 vs 17±3 cm/s,p = 0.007)和间隔e'(11±2 vs 13±2 cm/s,p = 0.009)组织速度以及较高的脉搏波速度(5.4±0.9 vs 4.8±0.5 m/s,p = 0.02)。在整个队列中,pAHI与脉搏波速度之间存在显著正相关(r = 0.42,p = 0.008),pAHI与平均e'组织速度之间存在负相关(r = -0.42,p = 0.01)。总之,SDB在年轻的大学ASF参与者中非常普遍,并且与心脏和血管功能的相对损伤有关。有针对性地努力识别包括ASF参与者在内的患有SDB的年轻人群,并实施SDB治疗方案,是未来重要的临床指导方向。