TY - JOUR
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 - Villarraga, 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 K.
AU - Lopez-Jimenez, Francisco
PY - 2010/5
Y1 - 2010/5
N2 - 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.
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.
KW - Echocardiography
KW - Obstructive sleep apnea
KW - Strain
KW - Ventricles
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U2 - 10.1161/CIRCIMAGING.109.901561
DO - 10.1161/CIRCIMAGING.109.901561
M3 - Article
C2 - 20160141
AN - SCOPUS:77953631429
SN - 1941-9651
VL - 3
SP - 282
EP - 289
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
IS - 3
ER -