TY - JOUR
T1 - Functional aerobic capacity in patients with sleep-disordered breathing
AU - Mansukhani, Meghna P.
AU - Allison, Thomas G.
AU - Lopez-Jimenez, Francisco
AU - Somers, Virend K.
AU - Caples, Sean M.
N1 - Funding Information:
V.K.S. has served as a Consultant for ResMed, Respicardia, Sova Pharmaceuticals, Neupro, Johnson & Johnson, and Apnex Medical; has been a principal investigator or co-investigator on research grants funded by Respironics Foundation and Sorin Corporation ; and is supported by Grant NIH R01 HL065176 from the National Institutes of Health , Bethesda, Maryland. SMC has received research support from Grant HL 99534 from the National Institutes of Health , Bethesda, Maryland; ResMed Foundation ; Ventus Medical ; and Restore Medical . The other authors have no disclosures. This study does not involve the use of off-label or investigational products.
PY - 2013/6/1
Y1 - 2013/6/1
N2 - Few studies have examined exercise capacity or cardiovascular responses to maximal exercise testing and recovery in patients with sleep-disordered breathing (SDB), and results from these studies are conflicting. The objective of this cross-sectional study conducted at a tertiary referral center was to examine the association between SDB and exercise testing outcomes independent of body mass index (BMI) and other cardiopulmonary risk factors. Between January 1, 2005 and January 1, 2010, 1,424 adults underwent exercise testing and within 6 months before first-time diagnostic polysomnography. Subjects were categorized by apnea-hypopnea index (AHI) into 4 groups: <5, 5 to 14, 15 to 29, and ≥30. A logistic regression model incorporated age, gender, BMI, smoking, hypertension, diabetes, beta-blocker use, and cardiac and pulmonary disease as covariates. The primary variable of interest was functional aerobic capacity (FAC). Mean age was 56.4 ± 12.4 years; 75% were men. Mean BMI was 32.4 ± 7.1 kg/m, and mean AHI 19.5 ± 22.1 per hour. On multivariate analysis, AHI as a continuous variable showed a negative correlation with FAC (Radj = 0.30, p <0.001) and postexercise SBP (Radj = 0.23, p = 0.03), and positively correlated with resting and peak DBP (Radj = 0.09, p = 0.01 and Radj = 0.09, p = 0.04 respectively). When comparing patients with severe SDB (AHI ≥30) with those without SDB (AHI <5), FAC and heart rate recovery were significantly lower, and resting, peak, and postexercise DBP were higher in those with severe apnea (all p <0.05), after accounting for confounders. In conclusion, SDB severity was associated with reduced FAC and increased resting and peak DBP. Even after accounting for confounders, severe SDB was associated with attenuated FAC, impaired heart rate recovery, and higher resting, peak, and postexercise DBP.
AB - Few studies have examined exercise capacity or cardiovascular responses to maximal exercise testing and recovery in patients with sleep-disordered breathing (SDB), and results from these studies are conflicting. The objective of this cross-sectional study conducted at a tertiary referral center was to examine the association between SDB and exercise testing outcomes independent of body mass index (BMI) and other cardiopulmonary risk factors. Between January 1, 2005 and January 1, 2010, 1,424 adults underwent exercise testing and within 6 months before first-time diagnostic polysomnography. Subjects were categorized by apnea-hypopnea index (AHI) into 4 groups: <5, 5 to 14, 15 to 29, and ≥30. A logistic regression model incorporated age, gender, BMI, smoking, hypertension, diabetes, beta-blocker use, and cardiac and pulmonary disease as covariates. The primary variable of interest was functional aerobic capacity (FAC). Mean age was 56.4 ± 12.4 years; 75% were men. Mean BMI was 32.4 ± 7.1 kg/m, and mean AHI 19.5 ± 22.1 per hour. On multivariate analysis, AHI as a continuous variable showed a negative correlation with FAC (Radj = 0.30, p <0.001) and postexercise SBP (Radj = 0.23, p = 0.03), and positively correlated with resting and peak DBP (Radj = 0.09, p = 0.01 and Radj = 0.09, p = 0.04 respectively). When comparing patients with severe SDB (AHI ≥30) with those without SDB (AHI <5), FAC and heart rate recovery were significantly lower, and resting, peak, and postexercise DBP were higher in those with severe apnea (all p <0.05), after accounting for confounders. In conclusion, SDB severity was associated with reduced FAC and increased resting and peak DBP. Even after accounting for confounders, severe SDB was associated with attenuated FAC, impaired heart rate recovery, and higher resting, peak, and postexercise DBP.
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U2 - 10.1016/j.amjcard.2013.02.008
DO - 10.1016/j.amjcard.2013.02.008
M3 - Article
C2 - 23578347
AN - SCOPUS:84877801612
SN - 0002-9149
VL - 111
SP - 1650
EP - 1654
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -