Reduced stroke volume related to pleural pressure in obstructive sleep apnea

F. A. Tolle, W. V. Judy, P. L. Yu, Omkar Markand

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Left ventricular stroke volume (LVSV) falls during obstructed inspiration in animals and normal human subjects through mechanisms that may be closely related to pleural pressure. In this study we postulated that a similar reduction in LVSV should occur in patients with obstructive sleep apnea (OSA). Daytime polysomnograms were performed in 10 patients with OSA. A noninvasive electrical impedance method was used to determine LVSV. Pleural pressure was measured by esophageal balloon. In comparison with awake values, during OSA we found reductions in LVSV, cardiac output, and heart rate of 18, 27, and 11%, respectively (P < 0.01). We observed that systolic pleural pressure did not have a significant effect on LVSV (P > 0.05). However, at pleural pressures lower than 10 cmH2O below resting expiratory level, there was a linear relationship between falls in LVSV and falls in middiastolic pleural pressure (P < 0.0001). We concluded that reduced LVSV shown in patients with OSA was significantly related to diastolic pleural pressure level. Our findings suggested reduced preload as the most likely mechanism for decreased cardiac output in OSA.

Original languageEnglish
Pages (from-to)1718-1724
Number of pages7
JournalJournal of Applied Physiology Respiratory Environmental and Exercise Physiology
Volume55
Issue number6
StatePublished - 1983

Fingerprint

Obstructive Sleep Apnea
Stroke Volume
Pressure
Cardiac Output
Electric Impedance
Heart Rate
Blood Pressure

ASJC Scopus subject areas

  • Endocrinology
  • Physiology

Cite this

Reduced stroke volume related to pleural pressure in obstructive sleep apnea. / Tolle, F. A.; Judy, W. V.; Yu, P. L.; Markand, Omkar.

In: Journal of Applied Physiology Respiratory Environmental and Exercise Physiology, Vol. 55, No. 6, 1983, p. 1718-1724.

Research output: Contribution to journalArticle

@article{3e90aec50ae743e38a737b0f7ac71995,
title = "Reduced stroke volume related to pleural pressure in obstructive sleep apnea",
abstract = "Left ventricular stroke volume (LVSV) falls during obstructed inspiration in animals and normal human subjects through mechanisms that may be closely related to pleural pressure. In this study we postulated that a similar reduction in LVSV should occur in patients with obstructive sleep apnea (OSA). Daytime polysomnograms were performed in 10 patients with OSA. A noninvasive electrical impedance method was used to determine LVSV. Pleural pressure was measured by esophageal balloon. In comparison with awake values, during OSA we found reductions in LVSV, cardiac output, and heart rate of 18, 27, and 11{\%}, respectively (P < 0.01). We observed that systolic pleural pressure did not have a significant effect on LVSV (P > 0.05). However, at pleural pressures lower than 10 cmH2O below resting expiratory level, there was a linear relationship between falls in LVSV and falls in middiastolic pleural pressure (P < 0.0001). We concluded that reduced LVSV shown in patients with OSA was significantly related to diastolic pleural pressure level. Our findings suggested reduced preload as the most likely mechanism for decreased cardiac output in OSA.",
author = "Tolle, {F. A.} and Judy, {W. V.} and Yu, {P. L.} and Omkar Markand",
year = "1983",
language = "English",
volume = "55",
pages = "1718--1724",
journal = "Journal of Applied Physiology",
issn = "8750-7587",
publisher = "American Physiological Society",
number = "6",

}

TY - JOUR

T1 - Reduced stroke volume related to pleural pressure in obstructive sleep apnea

AU - Tolle, F. A.

AU - Judy, W. V.

AU - Yu, P. L.

AU - Markand, Omkar

PY - 1983

Y1 - 1983

N2 - Left ventricular stroke volume (LVSV) falls during obstructed inspiration in animals and normal human subjects through mechanisms that may be closely related to pleural pressure. In this study we postulated that a similar reduction in LVSV should occur in patients with obstructive sleep apnea (OSA). Daytime polysomnograms were performed in 10 patients with OSA. A noninvasive electrical impedance method was used to determine LVSV. Pleural pressure was measured by esophageal balloon. In comparison with awake values, during OSA we found reductions in LVSV, cardiac output, and heart rate of 18, 27, and 11%, respectively (P < 0.01). We observed that systolic pleural pressure did not have a significant effect on LVSV (P > 0.05). However, at pleural pressures lower than 10 cmH2O below resting expiratory level, there was a linear relationship between falls in LVSV and falls in middiastolic pleural pressure (P < 0.0001). We concluded that reduced LVSV shown in patients with OSA was significantly related to diastolic pleural pressure level. Our findings suggested reduced preload as the most likely mechanism for decreased cardiac output in OSA.

AB - Left ventricular stroke volume (LVSV) falls during obstructed inspiration in animals and normal human subjects through mechanisms that may be closely related to pleural pressure. In this study we postulated that a similar reduction in LVSV should occur in patients with obstructive sleep apnea (OSA). Daytime polysomnograms were performed in 10 patients with OSA. A noninvasive electrical impedance method was used to determine LVSV. Pleural pressure was measured by esophageal balloon. In comparison with awake values, during OSA we found reductions in LVSV, cardiac output, and heart rate of 18, 27, and 11%, respectively (P < 0.01). We observed that systolic pleural pressure did not have a significant effect on LVSV (P > 0.05). However, at pleural pressures lower than 10 cmH2O below resting expiratory level, there was a linear relationship between falls in LVSV and falls in middiastolic pleural pressure (P < 0.0001). We concluded that reduced LVSV shown in patients with OSA was significantly related to diastolic pleural pressure level. Our findings suggested reduced preload as the most likely mechanism for decreased cardiac output in OSA.

UR - http://www.scopus.com/inward/record.url?scp=0021070195&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021070195&partnerID=8YFLogxK

M3 - Article

C2 - 6662762

AN - SCOPUS:0021070195

VL - 55

SP - 1718

EP - 1724

JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

SN - 8750-7587

IS - 6

ER -