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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 and Steiner, Stephan (2018) Impact of Continuous Positive Airway Pressure on Left Ventricular Systolic Loading and Coronary Flow Reserve in Healthy Young Men Heart, Lung and Circulation, 27 (3). pp. 344-349.

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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/ ± 6 years) at rest and during CPAP ventilation at pressures of 5, 10 mbar 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 [5 mbar], p < 0.01, to −12.2 ± 10.5% [10 mbar], p < 0.01) and systolic time integral as a marker of left ventricular workload (2115 ± 231 [rest] to 1978 ± 290 [5 mbar], p = 0.02 to 1940 ± 218 [10 mbar], p < 0.01 to 2013 ± 241 mmHg/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 10 mbar CPAP condition (1701 ± 300 [rest] to 1850 ± 301 dyn*s*m2/cm5 [10 mbar], 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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
Schulze, Volker
Meyer, Christian
Eickholt, Christian
Sansone, Roberto
Keymel, Stefanie
Rassaf, Tienush
Kelm, Malte
Steiner, Stephan
Date : 31 March 2018
DOI : 10.1016/j.hlc.2017.02.022
Uncontrolled Keywords : Augmentation index CPAP Workload Cardiovascular physiology Systolic time integral Buckberg index
Depositing User : Melanie Hughes
Date Deposited : 16 Aug 2018 14:05
Last Modified : 16 Aug 2018 14:05

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