Cerebral blood flow, oxygen metabolism, and lactate during hypoxia in patients with obstructive sleep apnea
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Cerebral blood flow, oxygen metabolism, and lactate during hypoxia in patients with obstructive sleep apnea. / Jensen, M L F; Vestergaard, M B; Tønnesen, P; Larsson, H B W; Jennum, Poul J.
In: Sleep, Vol. 41, No. 3, zsy001, 2018.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cerebral blood flow, oxygen metabolism, and lactate during hypoxia in patients with obstructive sleep apnea
AU - Jensen, M L F
AU - Vestergaard, M B
AU - Tønnesen, P
AU - Larsson, H B W
AU - Jennum, Poul J
PY - 2018
Y1 - 2018
N2 - Study Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of stroke but the underlying mechanism is poorly understood. We suspect that the normal cerebrovascular response to hypoxia is disturbed in patients with OSA.Methods: Global cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and lactate concentration during hypoxia were measured in patients with OSA and matched controls. Twenty-eight patients (82.1% males, mean age 52.3 ± 10.0 years) with moderate-to-severe OSA assessed by partial polysomnography were examined and compared with 19 controls (73.7% males, mean age 51.8 ± 10.1 years). Patients and controls underwent magnetic resonance imaging (MRI) during 35 min of normoxia followed by 35 min inhaling hypoxic air (10%-12% O2). After 3 months of continuous positive airway pressure (CPAP) treatment, 22 patients were rescanned.Results: During hypoxia, CBF significantly increased with decreasing arterial blood oxygen concentration (4.53 mL (blood)/100 g/min per -1 mmol(O2)/L, p < 0.001) in the control group, but was unchanged (0.89 mL (blood)/100 g/min per -1 mmol(O2)/L, p = 0.289) in the patient group before CPAP treatment. The CBF response to hypoxia was significantly weaker in patients than in controls (p = 0.003). After 3 months of CPAP treatment the CBF response normalized, showing a significant increase during hypoxia (5.15 mL (blood)/100 g/min per -1 mmol(O2)/L, p < 0.001). There was no difference in CMRO2 or cerebral lactate concentration between patients and controls, and no effect of CPAP treatment.Conclusions: Patients with OSA exhibit reduced CBF in response to hypoxia. CPAP treatment normalized these patterns.
AB - Study Objectives: Obstructive sleep apnea (OSA) is associated with increased risk of stroke but the underlying mechanism is poorly understood. We suspect that the normal cerebrovascular response to hypoxia is disturbed in patients with OSA.Methods: Global cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and lactate concentration during hypoxia were measured in patients with OSA and matched controls. Twenty-eight patients (82.1% males, mean age 52.3 ± 10.0 years) with moderate-to-severe OSA assessed by partial polysomnography were examined and compared with 19 controls (73.7% males, mean age 51.8 ± 10.1 years). Patients and controls underwent magnetic resonance imaging (MRI) during 35 min of normoxia followed by 35 min inhaling hypoxic air (10%-12% O2). After 3 months of continuous positive airway pressure (CPAP) treatment, 22 patients were rescanned.Results: During hypoxia, CBF significantly increased with decreasing arterial blood oxygen concentration (4.53 mL (blood)/100 g/min per -1 mmol(O2)/L, p < 0.001) in the control group, but was unchanged (0.89 mL (blood)/100 g/min per -1 mmol(O2)/L, p = 0.289) in the patient group before CPAP treatment. The CBF response to hypoxia was significantly weaker in patients than in controls (p = 0.003). After 3 months of CPAP treatment the CBF response normalized, showing a significant increase during hypoxia (5.15 mL (blood)/100 g/min per -1 mmol(O2)/L, p < 0.001). There was no difference in CMRO2 or cerebral lactate concentration between patients and controls, and no effect of CPAP treatment.Conclusions: Patients with OSA exhibit reduced CBF in response to hypoxia. CPAP treatment normalized these patterns.
KW - Adult
KW - Biomarkers/blood
KW - Cerebrovascular Circulation/physiology
KW - Continuous Positive Airway Pressure/methods
KW - Female
KW - Humans
KW - Hypoxia/blood
KW - Lactic Acid/blood
KW - Male
KW - Middle Aged
KW - Oxygen/blood
KW - Polysomnography/methods
KW - Sleep Apnea, Obstructive/blood
U2 - 10.1093/sleep/zsy001
DO - 10.1093/sleep/zsy001
M3 - Journal article
C2 - 29309697
VL - 41
JO - Sleep (Online)
JF - Sleep (Online)
SN - 0161-8105
IS - 3
M1 - zsy001
ER -
ID: 218088533