Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea

TUTLUOĞLU, Bülent; UTKUSAVAŞ, Ayfer; ÇUHADAROĞLU, Çağlar; Metin, Gökhan; OZTÜRK, LEVENT

Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea

Levent ÖZTÜRK, (Trakya Üniversitesi, Tıp Fakültesi, Fizyoloji Anabilim Dalı, Edirne, Türkiye)

Gökhan METİN, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Fizyoloji Anabilim Dalı, İstanbul, Türkiye)

Çağlar ÇUHADAROĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Ayfer UTKUSAVAŞ, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Bülent TUTLUOĞLU (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Tüberküloz ve Toraks

2 0

Yıl: 2005 Cilt: 53 Sayı: 1 Sayfa Aralığı: 10 - 19 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea

Öz:

Obstrüktif uyku apne (OSA) hastalarında egzersiz kısıtlılığının mekanizmaları ve maksimal kardiyopulmoner egzersiz testi (KPET)’nin güvenilirliği konusunda mevcut bilgi oldukça sınırlıdır. Bu çalışmada, orta-ileri derece OSA hastalarında egzersiz kapasitesinin değerlendirilmesi amaçlanmıştır. Ondokuz OSA hastası (üç kadın, 16 erkek) ile yaş ve vücut kitle indeksi bakımından benzer 11 gönüllü kontrol grubu (dört kadın, yedi erkek) egzersiz öncesi istirahat döneminde solunum fonksiyon testi ve daha sonra bisiklet ergometresinde maksimal KPET’ye alındı. Tüm çalışma grubu KPET’yi komplikasyonsuz tamamladı. Kontrol grubunda kondisyon eksikliğine bağlı egzersiz sınırlanması saptandı. Hasta grubunda egzersiz süresince ventilasyonda mekanik sınırlanma ya da kardiyak iskemi lehine bulgu saptanmadı. Beş hastada egzersiz sınırlanması yoktu; altı hastada ventrikül disfonksiyonu ile uyumlu olduğu düşünülen düşük VO2peak, düşük anaerobik eşik ve düşük oksijen nabzı gözlendi. Diğer altı hastada ise periferik damar hastalığını düşündüren düşük VO2peak, düşük anaerobik eşik ve hesaplanan maksimum kalp tepe atımının %85’inden daha düşük kalp tepe atımı saptandı. İki hastada ise kondisyon düşüklüğü ile uyumlu olarak düşük VO2peak, düşük anaerobik eşik ve maksimal egzersiz düzeyinde normal sınırlarda oksijen nabzı ve kalp tepe atımı gözlendi. Orta-ileri derece OSA hastalarında egzersiz kapasitesi düşüklüğünün daha sıklıkla ventrikül disfonksiyonu ya da periferik damar hastalığı gibi kardiyovasküler nedenlerden kaynaklanabileceği ve bu hasta grubunda maksimum KPET’nin ciddi komplikasyonlara neden olmadan tolere edilebileceği sonucuna varıldı.

Anahtar Kelime: Uyku apne, tıkayıcı Oksijen tüketimi Ergometri

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Orta ve ileri derece obstrüktif uyku apne sendromunda egzersize kardiyopulmoner yanıtlar

Öz:

Information regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in obstructive sleep apnea (OSA) patients is fairly limited. In the present study, we addressed the problem of exercise capacity in moderate-to-severe OSA patients. Nineteen non-consecutive patients (three female, 16 male) with moderateto- severe OSA and 11 age and body mass index matched control subjects (four female, seven male) underwent respiratory function tests during pre-exercise resting period and volitionally limited cardiopulmonary exercise testing on an electronically braked cycle ergometer. All participants completed CPET without any complication. Control subjects were exercise limited due to deconditioning. None of the patients revealed mechanical ventilatory limitation to exercise or had evidence of cardiac ischaemia. Five patients had no limitation to exercise. Six patients had low VO2peak, low anaerobic treshold (AT), and low peak O2 pulse, a pattern consistent with ventricular dysfunction. Six patients had low VO2peak, low AT, and peak heart rate less than 85% predicted. This pattern is consistent with exercise limitation due to peripheral vascular disease. Two patients had low VO2peak, low AT without peak oxygen pulse and peak heart rate abnormalities consistent with deconditioning. We concluded that moderate-to-severe OSA patients have impaired exercise capacity. Exercise limitation seems to originate from cardiovascular reasons namely left ventricular dysfunction and/or peripheral vascular impairment; and finally, maximal CPET can be tolerated by these patient group without serious complications.

Anahtar Kelime: Sleep Apnea, Obstructive Oxygen Consumption Ergometry

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

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APA	OZTÜRK L, Metin G, ÇUHADAROĞLU Ç, UTKUSAVAŞ A, TUTLUOĞLU B (2005). Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. , 10 - 19.
Chicago	OZTÜRK LEVENT,Metin Gökhan,ÇUHADAROĞLU Çağlar,UTKUSAVAŞ Ayfer,TUTLUOĞLU Bülent Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. (2005): 10 - 19.
MLA	OZTÜRK LEVENT,Metin Gökhan,ÇUHADAROĞLU Çağlar,UTKUSAVAŞ Ayfer,TUTLUOĞLU Bülent Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. , 2005, ss.10 - 19.
AMA	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. . 2005; 10 - 19.
Vancouver	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. . 2005; 10 - 19.
IEEE	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B "Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea." , ss.10 - 19, 2005.
ISNAD	OZTÜRK, LEVENT vd. "Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea". (2005), 10-19.

APA	OZTÜRK L, Metin G, ÇUHADAROĞLU Ç, UTKUSAVAŞ A, TUTLUOĞLU B (2005). Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tüberküloz ve Toraks, 53(1), 10 - 19.
Chicago	OZTÜRK LEVENT,Metin Gökhan,ÇUHADAROĞLU Çağlar,UTKUSAVAŞ Ayfer,TUTLUOĞLU Bülent Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tüberküloz ve Toraks 53, no.1 (2005): 10 - 19.
MLA	OZTÜRK LEVENT,Metin Gökhan,ÇUHADAROĞLU Çağlar,UTKUSAVAŞ Ayfer,TUTLUOĞLU Bülent Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tüberküloz ve Toraks, vol.53, no.1, 2005, ss.10 - 19.
AMA	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tüberküloz ve Toraks. 2005; 53(1): 10 - 19.
Vancouver	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tüberküloz ve Toraks. 2005; 53(1): 10 - 19.
IEEE	OZTÜRK L,Metin G,ÇUHADAROĞLU Ç,UTKUSAVAŞ A,TUTLUOĞLU B "Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea." Tüberküloz ve Toraks, 53, ss.10 - 19, 2005.
ISNAD	OZTÜRK, LEVENT vd. "Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea". Tüberküloz ve Toraks 53/1 (2005), 10-19.