Dados do Trabalho

Título

ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SEVERITY AND RESPONSES TO CARDIOPULMONARY EXERCISE TEST

Introdução

Patients with obstructive sleep apnea (OSA) are known to have a high cardiovascular risk, and studies have shown that these patients exhibit hemodynamic changes during the cardiopulmonary exercise test (CPET), which is one of the primary methods for assessing cardiovascular risk during exercise. However, the impact of the disease severity on these responses is not yet clear.

Objetivo

To analyze the association between OSA severity and cardiovascular responses to CPET.

Métodos

Fifty-nine patients with OSA (55.8 ± 10.4 yrs. 54.2% female, 19.3% mild, 28.1% moderate and 52.6% severe OSA) participated in the study. The CPET was conducted on a treadmill using the Bruce protocol, with continuous ECG monitoring throughout the test and recovery period, providing the maximum heart rate achieved during the CPET. Blood pressure was measured at the end of each stage (3 minute) by a specialist. The test was terminated if diastolic blood pressure reached ≥120 mmHg in normotensive individuals or ≥140 mmHg in hypertensive individuals, if systolic blood pressure reached ≥260 mmHg, if there was a sustained decrease in systolic blood pressure, or if clinical symptoms such as chest pain, syncope or near-syncope, or ECG changes consistent with ischemia occurred. The apnea–hypopnea index (AHI) was assessed by full polysomnography in a sleep laboratory. Body mass index and comorbid conditions were assessed. Multiple linear regression was used to assess the relationship between CPET responses and OSA severity.

Resultados

AHI was positively associated with maximum systolic blood pressure [β=0.607 (0,185) mmHg; b=0.437, p=0.002] and maximum heart rate [β=0.256 (0,101); b=0.291, p=0.014], independent of age, body mass index, sex, and hypertension of patients. Diastolic blood pressure was not associated with AHI.

Conclusões

Patients with greater OSA severity exhibit higher systolic blood pressure and maximum heart rate values during a progressive exercise test.

Palavras -chave

Exercise test; Blood pressure; Obstructive sleep apnea.