Changes in left and right ventricular mechanics during the Mueller maneuver in healthy Adults a possible mechanism for abnormal cardiac function in patients with obstructive sleep apnea

Yuki Koshino, Hector R Vilarraga, Marek Orban, Charles J Bruce, Gregg S. Pressman, Pavel Leinveber, Haydar K. Saleh, Tomas Konecny, Tomas Kara, Virend Somers, Francisco Lopez-Jimenez

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background-Obstructive sleep apnea is highly prevalent in patients with cardiovascular disease and has detrimental effects on systolic and diastolic function of the ventricles. In this research, the changes in strain (S) and strain rate (SR) during the performance of the Mueller maneuver (MM) in an effort to better understand how negative intrathoracic pressures affect ventricular mechanics. Methods and Results-The MM was performed to maintain a target intrathoracic pressure of -40 mm Hg. Echocardiography was used to measure various parameters of cardiac structure and function. Myocardial deformation measurements were performed using tissue speckle tracking. Twenty-four healthy subjects (9 women; mean age, 30±6 years) were studied. Global left ventricular longitudinal S in systole and SR in early filling were significantly decreased during the MM (S: baseline, -17.0±1.6%; MM, -14.5±2.2%; P<0.0001, SR: baseline, 1.09±0.20 s-1; MM, 0.92±0.21 s-1; P=0.01). Global right ventricular longitudinal S was also significantly decreased during the MM (baseline, -22.0±3.1%; MM, -17.2±2.5%; P<0.0001), as was global right ventricular longitudinal systolic SR (baseline, -1.34±0.35 s-1; MM, -1.02±0.21 s-1; P=0.0006). Conclusions-Left ventricular and right ventricular longitudinal deformation are significantly reduced during the MM. These results suggest that negative intrathoracic pressure during apnea may contribute to changes in myocardial mechanics. These results could help explain the observed changes in left ventricular and right ventricular mechanics in patients with obstructive sleep apnea.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume3
Issue number3
DOIs
StatePublished - May 2010

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Obstructive Sleep Apnea
Mechanics
Pressure
Systole
Ventricular Pressure
Apnea
Echocardiography
Healthy Volunteers
Cardiovascular Diseases
Research

Keywords

  • Echocardiography
  • Obstructive sleep apnea
  • Strain
  • Ventricles

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Changes in left and right ventricular mechanics during the Mueller maneuver in healthy Adults a possible mechanism for abnormal cardiac function in patients with obstructive sleep apnea. / Koshino, Yuki; Vilarraga, Hector R; Orban, Marek; Bruce, Charles J; Pressman, Gregg S.; Leinveber, Pavel; Saleh, Haydar K.; Konecny, Tomas; Kara, Tomas; Somers, Virend; Lopez-Jimenez, Francisco.

In: Circulation: Cardiovascular Imaging, Vol. 3, No. 3, 05.2010, p. 282-289.

Research output: Contribution to journalArticle

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abstract = "Background-Obstructive sleep apnea is highly prevalent in patients with cardiovascular disease and has detrimental effects on systolic and diastolic function of the ventricles. In this research, the changes in strain (S) and strain rate (SR) during the performance of the Mueller maneuver (MM) in an effort to better understand how negative intrathoracic pressures affect ventricular mechanics. Methods and Results-The MM was performed to maintain a target intrathoracic pressure of -40 mm Hg. Echocardiography was used to measure various parameters of cardiac structure and function. Myocardial deformation measurements were performed using tissue speckle tracking. Twenty-four healthy subjects (9 women; mean age, 30±6 years) were studied. Global left ventricular longitudinal S in systole and SR in early filling were significantly decreased during the MM (S: baseline, -17.0±1.6{\%}; MM, -14.5±2.2{\%}; P<0.0001, SR: baseline, 1.09±0.20 s-1; MM, 0.92±0.21 s-1; P=0.01). Global right ventricular longitudinal S was also significantly decreased during the MM (baseline, -22.0±3.1{\%}; MM, -17.2±2.5{\%}; P<0.0001), as was global right ventricular longitudinal systolic SR (baseline, -1.34±0.35 s-1; MM, -1.02±0.21 s-1; P=0.0006). Conclusions-Left ventricular and right ventricular longitudinal deformation are significantly reduced during the MM. These results suggest that negative intrathoracic pressure during apnea may contribute to changes in myocardial mechanics. These results could help explain the observed changes in left ventricular and right ventricular mechanics in patients with obstructive sleep apnea.",
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T1 - Changes in left and right ventricular mechanics during the Mueller maneuver in healthy Adults a possible mechanism for abnormal cardiac function in patients with obstructive sleep apnea

AU - Koshino, Yuki

AU - Vilarraga, Hector R

AU - Orban, Marek

AU - Bruce, Charles J

AU - Pressman, Gregg S.

AU - Leinveber, Pavel

AU - Saleh, Haydar K.

AU - Konecny, Tomas

AU - Kara, Tomas

AU - Somers, Virend

AU - Lopez-Jimenez, Francisco

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AB - Background-Obstructive sleep apnea is highly prevalent in patients with cardiovascular disease and has detrimental effects on systolic and diastolic function of the ventricles. In this research, the changes in strain (S) and strain rate (SR) during the performance of the Mueller maneuver (MM) in an effort to better understand how negative intrathoracic pressures affect ventricular mechanics. Methods and Results-The MM was performed to maintain a target intrathoracic pressure of -40 mm Hg. Echocardiography was used to measure various parameters of cardiac structure and function. Myocardial deformation measurements were performed using tissue speckle tracking. Twenty-four healthy subjects (9 women; mean age, 30±6 years) were studied. Global left ventricular longitudinal S in systole and SR in early filling were significantly decreased during the MM (S: baseline, -17.0±1.6%; MM, -14.5±2.2%; P<0.0001, SR: baseline, 1.09±0.20 s-1; MM, 0.92±0.21 s-1; P=0.01). Global right ventricular longitudinal S was also significantly decreased during the MM (baseline, -22.0±3.1%; MM, -17.2±2.5%; P<0.0001), as was global right ventricular longitudinal systolic SR (baseline, -1.34±0.35 s-1; MM, -1.02±0.21 s-1; P=0.0006). Conclusions-Left ventricular and right ventricular longitudinal deformation are significantly reduced during the MM. These results suggest that negative intrathoracic pressure during apnea may contribute to changes in myocardial mechanics. These results could help explain the observed changes in left ventricular and right ventricular mechanics in patients with obstructive sleep apnea.

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