Parasympathetic Modulation of Heart Rate in Obesity-Hypoventilation Patients

 

OSA (n = 23)

OH (n = 18)

Age (yr)

57.9 ± 6.6

56.6 ± 6.6

Weight (kg)

117.7 ± 23.5

127.9 ± 18.3

Height (m)

1.70 ± 0.09

1.76 ± 0.10*

BMI (kg/m2)

41.7 ± 6.6

41.4 ± 7.0

ESS (points)

8.0 ± 3.2

11.7 ± 6.0

PaCO2 (mmHg)

41.3 ± 3.7

49.5 ± 3.7**

HCO3 (mmol/l)

26.7 ± 1.9

29.8 ± 1.8**

PaO2 (mmHg)

64.6 ± 6.8

58.4 ± 8.4*

SaO2 (%)

92.3 ± 2.9

89.5 ± 3.7*

pH

7.43 ± 0.03

7.40 ± 0.02**

VC (l)

3.5 ± 1.0

3.5 ± 9.4

VC (% of predicted)

97.9 ± 13.5

78.0 ± 14.4**

FEV1 (l)

2.7 ± 5.3

2.6 ± 8.3

FEV1 (% of predicted)

94.0 ± 14.9

77.0 ± 17.5**

FEV1/FVC (%)

80.5 ± 15.4

77.4 ± 11.3

AHI (episodes/hour)

43.8 ± 18.0

58.7 ± 38.0

SaO2, mean of minimal at the end of apnea/hypopnea (%)

82.5 ± 6.4

79.2 ± 6.9

SaO2, average nocturnal (%)

87.2 ± 4.7

83.8 ± 5.9

SaO2, minimal nocturnal (%)

67.6 ± 11.6

66.9 ± 10.9


Data are means ± SD

OSA obstructive sleep apnea, OH obesity hypoventilation, BMI body mass index, ESS Epworth Sleepiness Scale, PaCO 2 arterial pressure of carbon dioxide, HCO 3 bicarbonate ion, PaO 2 arterial oxygen partial pressure, SaO 2 arterial oxygen saturation, VC vital capacity, FEV 1 forced expired volume in one second, and AHI apnea/hypopnea index

*p < 0.05; **p < 0.01



The results of time-domain parameters of HRV are presented in the Table 2. In the OH syndrome there were significantly lower values of SDNN, SDNN index, RMSSD, and SDANN, compared with OSA, with no appreciable differences in NN50c, NN50%, and TI. Concerning the frequency-domain of HRV, LF/HF ratio was significantly greater in the OH than that in OSA patients (Table 3).


Table 2
Time-domain parameters of HRV in patients with ‘pure’ OSA and OH syndromes







































 
OSA (n = 23)
OH (n = 18)

SDNN
155 (80–230)
117 (70–396)*

SDNN index
151 (60–326)
100 (40–388)*

RMSSD
183 (40–453)
98 (29–605)*

NN50c
3,171 (27–9,629)
3,768 (500–11,737)

NN50%HR
19 (6–79)
18 (2–56)

SDANN
261 (31–4,582)
105 (45–577)*

TI
16 (9–29)
16 (10–26)


Data are medians (min-max)

OSA obstructive sleep apnea, OH obesity-hypoventilation, SDNN standard deviation of all NN, i.e., distances between consecutive R-R intervals (ms), SDNN index mean of the standard deviations of all NN intervals (ms), SDANN standard deviation of the averages of NN intervals (ms), RMSSD square root of the mean of the sum of the squares of differences between adjacent NN intervals (ms), NN50c number of interval differences of successive NN intervals greater than 50 ms, NN50% the proportion derived by dividing NN50 by the total number of NN intervals, and TI triangular index

*p < 0.05



Table 3
Frequency-domain parameters of HRV in patients with ‘pure’ OSA and OH syndromes































 
OSA (n = 23)
OH (n = 18)

TP
17,415 (3,190–126,666)
29,231 (8,711–96,914)

VLF
5,865 (606–68,265)
12,619 (1,352–60,972)

LF
5,612 (891–34,436)
8,359 (2,357–30,980)

HF
2,783 (466–7,541)
2,546 (976–6,750)

LF/HF
1.9 (0.9–7.5)
3.0 (1.7–9.0)*


Data are medians (min-max)

OSA obstructive sleep apnea, OH obesity-hypoventilation, TP total power, i.e., variance of NN intervals (ms2), VLF power in very low frequency range (ms2), LF power in low frequency range (ms2), HF power in high frequency range (ms2), and LF/HF ratio
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Jul 10, 2016 | Posted by in RESPIRATORY | Comments Off on Parasympathetic Modulation of Heart Rate in Obesity-Hypoventilation Patients

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