CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities
<i>Background and Objectives:</i> Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic d...
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| Format: | Article |
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MDPI AG
2020-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/2/80 |
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| author | Ioana Mădălina Zota Cristian Stătescu Radu Andy Sascău Mihai Roca Radu Sebastian Gavril Teodor Flaviu Vasilcu Daniela Boișteanu Alexandra Maștaleru Alexandra Jitaru Maria Magdalena Leon Constantin Florin Mitu |
| author_facet | Ioana Mădălina Zota Cristian Stătescu Radu Andy Sascău Mihai Roca Radu Sebastian Gavril Teodor Flaviu Vasilcu Daniela Boișteanu Alexandra Maștaleru Alexandra Jitaru Maria Magdalena Leon Constantin Florin Mitu |
| author_sort | Ioana Mădălina Zota |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual’s aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). <i>Materials and Methods:</i> Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (Δ = 14.23 W, <i>p</i> = 0.0004), maximum oxygen uptake (Δ = 203.87 mL/min, <i>p</i> = 0.004), anaerobic threshold (Δ = 316.4 mL/min, <i>p</i> = 0.001), minute ventilation (Δ = 5.1 L/min, <i>p</i> = 0.01) and peak oxygen pulse (Δ = 2.46, <i>p</i> = 0.007) as well as a decrease in basal metabolic rate (BMR) (Δ = −8.3 kCal/24 h, <i>p</i> = 0.04) and average Epworth score (Δ = −4.58 points, <i>p</i> < 0.000001). <i>Conclusions:</i> Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity. |
| first_indexed | 2024-03-12T06:02:34Z |
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| language | English |
| last_indexed | 2024-03-12T06:02:34Z |
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| spelling | doaj.art-21ebc2308e0f41b884b0a1aaa7a9dd992023-09-03T03:58:33ZengMDPI AGMedicina1010-660X2020-02-015628010.3390/medicina56020080medicina56020080CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic ComorbiditiesIoana Mădălina Zota0Cristian Stătescu1Radu Andy Sascău2Mihai Roca3Radu Sebastian Gavril4Teodor Flaviu Vasilcu5Daniela Boișteanu6Alexandra Maștaleru7Alexandra Jitaru8Maria Magdalena Leon Constantin9Florin Mitu10Department of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (III), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa—University of Medicine and Pharmacy, 700115 Iași, Romania<i>Background and Objectives:</i> Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual’s aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). <i>Materials and Methods:</i> Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (Δ = 14.23 W, <i>p</i> = 0.0004), maximum oxygen uptake (Δ = 203.87 mL/min, <i>p</i> = 0.004), anaerobic threshold (Δ = 316.4 mL/min, <i>p</i> = 0.001), minute ventilation (Δ = 5.1 L/min, <i>p</i> = 0.01) and peak oxygen pulse (Δ = 2.46, <i>p</i> = 0.007) as well as a decrease in basal metabolic rate (BMR) (Δ = −8.3 kCal/24 h, <i>p</i> = 0.04) and average Epworth score (Δ = −4.58 points, <i>p</i> < 0.000001). <i>Conclusions:</i> Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity.https://www.mdpi.com/1010-660X/56/2/80obstructive sleep apneacontinuous positive airway treatmentcardiopulmonary exercise testingfunctional capacitycardiovascular rehabilitation |
| spellingShingle | Ioana Mădălina Zota Cristian Stătescu Radu Andy Sascău Mihai Roca Radu Sebastian Gavril Teodor Flaviu Vasilcu Daniela Boișteanu Alexandra Maștaleru Alexandra Jitaru Maria Magdalena Leon Constantin Florin Mitu CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities Medicina obstructive sleep apnea continuous positive airway treatment cardiopulmonary exercise testing functional capacity cardiovascular rehabilitation |
| title | CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities |
| title_full | CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities |
| title_fullStr | CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities |
| title_full_unstemmed | CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities |
| title_short | CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities |
| title_sort | cpap effect on cardiopulmonary exercise testing performance in patients with moderate severe osa and cardiometabolic comorbidities |
| topic | obstructive sleep apnea continuous positive airway treatment cardiopulmonary exercise testing functional capacity cardiovascular rehabilitation |
| url | https://www.mdpi.com/1010-660X/56/2/80 |
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