TY - JOUR
T1 - Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea
AU - Kline, Christopher E.
AU - Crowley, E. Patrick
AU - Ewing, Gary B.
AU - Burch, James B.
AU - Blair, Steven N.
AU - Durstine, J. Larry
AU - Davis, J. Mark
AU - Youngstedt, Shawn D.
N1 - Funding Information:
This work was supported by Public Health Dissertation Grant 1R36CD000695-1 from the Centers for Disease Control and Prevention (CDC) . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. Additional funding support for this work was provided by NHLBI T32 HL082610-05 .
PY - 2013/8/20
Y1 - 2013/8/20
N2 - Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.
AB - Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.
KW - Exercise testing
KW - Exercise training
KW - Heart rate recovery
KW - Obstructive sleep apnea
KW - Peak oxygen consumption
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U2 - 10.1016/j.ijcard.2012.04.108
DO - 10.1016/j.ijcard.2012.04.108
M3 - Article
C2 - 22572632
AN - SCOPUS:84881480725
SN - 0167-5273
VL - 167
SP - 1610
EP - 1615
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 4
ER -