title: Obstructive sleep apnoea-hypoapnoea syndrome reversibly depresses cardiac response to exercise.
abstract: OBJECTIVE
  To evaluate cardiac response to exercise in middle-aged normotensive obstructive sleep apnoea-hypoapnoea syndrome (OSAHS) adults with normal resting left ventricular systolic function and to test the hypothesis that nasal continuous positive airway pressure (CPAP) therapy might improve cardiac performance during exercise.
  
  
  RESULTS
  We performed a prospective, randomized, double-blind, placebo-controlled, cross-over clinical trial including 31 consecutive newly diagnosed OSAHS patients and 15 healthy subjects. Cardiopulmonary exercise testing with cardiac output measurement, blood pressure (BP) recordings, and urinary excretion of catecholamine levels were obtained at baseline and after 3 months on both effective and sham CPAP. OSAHS subjects had higher systolic and mean nocturnal BP and higher nocturnal levels of catecholamines. In contrast, they had lower increments in cardiac output (Qt) and in stroke volume (SV) in response to exercise than control subjects. CPAP therapy was associated with highly significant improvements in all the indices of left ventricular systolic performance response during exercise, whereas with sham CPAP, all of them remained unchanged.
  
  
  CONCLUSIONS
  OSAHS patients with normal resting left ventricular systolic function and no hypertension had a worse cardiac response to exercise than healthy subjects. In these patients, 3 months of CPAP improved both Qt and SV responses to exercise.
authors.affiliation: Servicio de Neumología, Hospital Universitario La Paz, Alfredo Marqueríe 11, 28034 Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alonso-Fernández
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Río
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arias
authors.forename: Olga
authors.initials: O
authors.lastname: Mediano
authors.forename: José M
authors.initials: JM
authors.lastname: Pino
authors.forename: Isabel
authors.initials: I
authors.lastname: Martínez
authors.forename: José
authors.initials: J
authors.lastname: Villamor
mesh_terms: D000704:Analysis of Variance; D002303:Cardiac Output, Low; D045422:Continuous Positive Airway Pressure; D018592:Cross-Over Studies; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy