Sleep-Disordered Breathing Exacerbates Muscle Vasoconstriction and Sympathetic Neural Activation in Patients with Systolic Heart Failure

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dc.citation.issue11
dc.citation.volume9
dc.contributor.authorLobo, Denise M. L.
dc.contributor.authorTrevizan, Patricia F.
dc.contributor.authorToschi-Dias, Edgar
dc.contributor.authorOliveira, Patricia A.
dc.contributor.authorPiveta, Rafael B.
dc.contributor.authorAlmeida, Dirceu Rodrigues de [UNIFESP]
dc.contributor.authorMady, Charles
dc.contributor.authorBocchi, Edimar A.
dc.contributor.authorLorenzi-Filho, Geraldo
dc.contributor.authorMiddlekauff, Holly R.
dc.contributor.authorNegrao, Carlos E.
dc.coveragePhiladelphia
dc.date.accessioned2020-07-31T12:47:25Z
dc.date.available2020-07-31T12:47:25Z
dc.date.issued2016
dc.description.abstractBackground-Sleep-disordered breathing (SDB) is common in patients with heart failure (HF), and hypoxia and hypercapnia episodes activate chemoreceptors stimulating autonomic reflex responses. We tested the hypothesis that muscle vasoconstriction and muscle sympathetic nerve activity (MSNA) in response to hypoxia and hypercapnia would be more pronounced in patients with HF and SDB than in patients with HF without SDB (NoSBD). Methods and Results-Ninety consecutive patients with HF, New York Heart Association functional class II-III, and left ventricular ejection fraction <= 40% were screened for the study. Forty-one patients were enrolled: NoSDB (n=13, 46 [39-53] years) and SDB (n=28, 57 [54-61] years). SDB was characterized by apnea-hypopnea index >= 15 events per hour (polysomnography). Peripheral (10% O-2 and 90% N-2, with CO2 titrated) and central (7% CO2 and 93% O-2) chemoreceptors were stimulated for 3 minutes. Forearm and calf blood flow were evaluated by venous occlusion plethysmography, MSNA by microneurography, and blood pressure by beat-to-beat noninvasive technique. Baseline forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance were similar between groups. MSNA was higher in the SDB group. During hypoxia, the vascular responses (forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance) were significantly lower in the SDB group compared with the NoSDB group (P<0.01 to all comparisons). Similarly, during hypercapnia, the vascular responses (forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance) were significantly lower in the SDB group compared with the NoSDB group (P<0.001 to all comparisons). MSNA were higher in response to hypoxia (P=0.024) and tended to be higher to hypercapnia (P=0.066) in the SDB group. Conclusions-Patients with HF and SDB have more severe muscle vasoconstriction during hypoxia and hypercapnia than HF patients without SDB, which seems to be associated with endothelial dysfunction and, in part, increased MSNA response.en
dc.description.affiliationUniv Sao Paulo, Heart Inst InCor, Sch Med, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Radiol Inst InRad, Sch Med, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Div Cardiol, Dept Med, Sao Paulo, Brazil
dc.description.affiliationUniv Calif Los Angeles, Sch Med, Los Angeles, CA USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo (UNIFESP), Division of Cardiology, Department of Medicine, Federal University of São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipNational Institutes of Health
dc.description.sponsorshipIDFAPESP: 2010/50048-1
dc.description.sponsorshipIDFAPESP: 2013/07651-7
dc.description.sponsorshipIDCNPq: 140265/2013-9
dc.description.sponsorshipIDCNPq: 309737/2013-3
dc.description.sponsorshipIDCNPq: 301867/2010-0
dc.description.sponsorshipIDNIH: NIH-R01-HL084525
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1161/CIRCHEARTFAILURE.116.003065
dc.identifier.citationCirculation-Heart Failure. Philadelphia, v. 9, n. 11, p. -, 2016.
dc.identifier.doi10.1161/CIRCHEARTFAILURE.116.003065
dc.identifier.issn1941-3289
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56820
dc.identifier.wosWOS:000388664100002
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofCirculation-Heart Failure
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectchemoreceptor cellsen
dc.subjectheart failureen
dc.subjectregional blood flowen
dc.subjectsleep apnea syndromesen
dc.subjectsympathetic nervous systemen
dc.titleSleep-Disordered Breathing Exacerbates Muscle Vasoconstriction and Sympathetic Neural Activation in Patients with Systolic Heart Failureen
dc.typeinfo:eu-repo/semantics/article
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