Detail publikace

Effects of the Mueller Maneuver on Functional Mitral Regurgitation and Implications for Obstructive Sleep Apnea

PRESSMAN, G.S., ORBAN, M., LEINVEBER, P., PAREKH, K., SINGH, M., KARA, T., SOMERS, V.K.

Originální název

Effects of the Mueller Maneuver on Functional Mitral Regurgitation and Implications for Obstructive Sleep Apnea

Typ

článek v časopise ve Web of Science, Jimp

Jazyk

angličtina

Originální abstrakt

Obstructive sleep apnea is prevalent and adversely affects cardiovascular health. However, little is known of the acute effects of an obstructive apnea on cardiovascular physiology. We hypothesized that pre-existing functional mitral regurgitation (MR) would worsen during performance of a Mueller maneuver (MM) used to simulate an obstructive apnea; 15 subjects with an ejection fraction <= 35% and pre-existing functional MR were studied with Doppler echocardiography. The radius of the proximal flow convergence was used as a measure of mitral regurgitant flow. Measurements were made at baseline, during the MM, and post-MM. Areas of all 4 chambers were also measured at these time points, both in systole and diastole. Mean flow convergence radius for the group decreased significantly during the transition from the late-MM to post-MM (0.65/0.57 mm, p[0.001), implying increased MR during the MM. In addition, in 3 subjects, duration of MR increased during the MM. Right atrial (RA) areas, both systolic and diastolic, increased during the maneuver, whereas RA fractional area change decreased, indicating reduced RA emptying. Left ventricular emptying decreased early in the maneuver, probably because of the increased afterload burden, and then recovered. In conclusion, high negative intrathoracic pressure produces changes that, repeated hundreds of times per night in patients with obstructive sleep apnea, have the potential to worsen heart failure and predispose affected subjects to atrial fibrillation.

Klíčová slova

Obstructive Sleep Apnea; Mitral regurgitation; Cardiovascular physiology

Autoři

PRESSMAN, G.S., ORBAN, M., LEINVEBER, P., PAREKH, K., SINGH, M., KARA, T., SOMERS, V.K.

Rok RIV

2015

Vydáno

1. 6. 2015

Nakladatel

Elsevier

Místo

USA

ISSN

0002-9149

Periodikum

AMERICAN JOURNAL OF CARDIOLOGY

Ročník

115

Číslo

11

Stát

Spojené státy americké

Strany od

1563

Strany do

1567

Strany počet

5

URL

http://www.ajconline.org/article/S0002-9149(15)00905-4/abstract

BibTex

@article{BUT116705,
  author="Pavel {Leinveber}",
  title="Effects of the Mueller Maneuver on Functional Mitral Regurgitation and Implications for Obstructive Sleep Apnea",
  journal="AMERICAN JOURNAL OF CARDIOLOGY",
  year="2015",
  volume="115",
  number="11",
  pages="1563--1567",
  doi="10.1016/j.amjcard.2015.02.061",
  issn="0002-9149",
  url="http://www.ajconline.org/article/S0002-9149(15)00905-4/abstract"
}