CARDIOPULMONARY STRESS TEST PERFORMANCE IN PATIENTS WITH MODERATE-SEVERE OBSTRUCTIVE SLEEP APNEA
2019
CARDIOPULMONARY STRESS TEST PERFORMANCE IN PATIENTS WITH MODERATE-SEVERE OBSTRUCTIVE SLEEP APNEA (Abstract): Introduction: Cardiopulmonary stress test (CPET) is an important part of risk stratification and prognostic assessment of a cardiovascular patient. Since obstructive sleep apnea (OSA) is a frequent finding in patients with cardiovascular and metabolic comorbidities, the role of CPET in the evaluation of patients with sleep disordered breathing is a subject of great interest. Aim: To illustrate the role of CPET evaluation in OSA patients, before and after noninvasive ventilation. Material and methods: We performed a prospective study that included 27 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) ≥ 15) who underwent a cardiopulmonary stress test before and after 2 months of continuous positive airway pressure (CPAP therapy). We compared baseline CPET performance between OSA patients and 27 age and BMI matched controls. Results: OSA severity was not significantly correlated with any of the analyzed baseline CPET parameters. CPET performance did not significantly differ between controls and patients with moderate-severe, moderate or severe OSA. Eight weeks of CPAP therapy lead to a significant improvement in weight status and several CPET parameters, including effort capacity (maximal and percent predicted load), oxygen pulse and percent-predicted oxygen uptake. Conclusions: Age, but not AHI, influence baseline CPET results. Although we did not find significant differences between CPET performance in OSA patients and controls, 2 months of CPAP therapy was associated with a significant improvement in exercise tolerance and CPET parameters, suggesting that OSA negatively impacts exercise tolerance.
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