阻塞性睡眠呼吸暂停对运动时心肺功能、内皮功能障碍和肺动脉高压的影响。
Impact of obstructive sleep apnea on cardiopulmonary performance, endothelial dysfunction, and pulmonary hypertension during exercise.
机构信息
Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada; Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA, United States.
Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA, United States.
出版信息
Respir Physiol Neurobiol. 2021 Jan;283:103557. doi: 10.1016/j.resp.2020.103557. Epub 2020 Oct 1.
RATIONALE
OSA has been associated with reduced exercise capacity. Endothelial dysfunction and exercise-induced pulmonary hypertension (ePH) may be mediators of this impairment. We hypothesized that OSA severity would be associated with impaired exercise performance, endothelial dysfunction, and ePH.
METHODS
Subjects with untreated OSA were recruited. Subjects underwent endothelial function, and cardiopulmonary exercise testing with an echocardiogram immediately before and following exercise.
RESULTS
22 subjects were recruited with mean age 56 ± 8 years, 74 % male, BMI 29 ± 3 kg/m, and AHI 22 ± 12 events/hr. Peak V˙O did not differ from normal (99.7 ± 17.3 % predicted; p = 0.93). There was no significant association between OSA severity (as AHI, ODI) and exercise capacity, endothelial function, or pulmonary artery pressure. However, ODI, marker of RV diastolic dysfunction, and BMI together explained 59.3 % of the variability of exercise performance (p < 0.001) via our exploratory analyses.
CONCLUSIONS
Exercise capacity was not impaired in this OSA cohort. Further work is needed to elucidate mechanisms linking sleep apnea, obesity, endothelial dysfunction and exercise impairment.
背景
阻塞性睡眠呼吸暂停（OSA）与运动能力降低有关。血管内皮功能障碍和运动诱导性肺动脉高压（ePH）可能是导致这种损伤的介质。我们假设 OSA 的严重程度与运动表现受损、内皮功能障碍和 ePH 有关。
方法
招募了未经治疗的 OSA 患者。患者在运动前后进行内皮功能和心肺运动测试，并进行超声心动图检查。
结果
共招募了 22 名患者，平均年龄 56 ± 8 岁，74%为男性，BMI 29 ± 3 kg/m2，AHI 22 ± 12 次/小时。峰值 V˙O 与正常水平无差异（99.7 ± 17.3%预测值；p = 0.93）。OSA 严重程度（如 AHI、ODI）与运动能力、内皮功能或肺动脉压之间无显著相关性。然而，通过我们的探索性分析，ODI（反映右心室舒张功能障碍的标志物）和 BMI 共同解释了运动表现变异性的 59.3%（p < 0.001）。
结论
在这个 OSA 队列中，运动能力没有受损。需要进一步研究阐明睡眠呼吸暂停、肥胖、内皮功能障碍和运动损伤之间的联系机制。
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