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J Appl Physiol 91: 2359-2365, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 5, 2359-2365, November 2001

Peripheral vascular resistance increases after termination of obstructive apneas

Amit Anand1,3,4, Stacia Remsburg-Sailor1,2,3,4, Sandrine H. Launois1,3,4, and J. Woodrow Weiss1,2,3,4

1 Charles A. Dana Institute and Harvard-Thorndike Laboratory of Beth Israel Deaconess Medical Center, 2 Beth Israel Deaconess Sleep Disorders Center, 3 Department of Medicine, Beth Israel Deaconess Medical Center, and 4 Department of Medicine, Harvard Medical School, Boston, Massachusetts 02215

The mechanisms by which obstructive apneas produce intermittent surges in arterial pressure remain poorly defined. To determine whether termination of obstructive apneas produce peripheral vasoconstriction, we assessed forearm blood flow during and after obstructive events in sleeping patients experiencing spontaneous upper airway obstructions. In all subjects, heart rate was monitored with an electrocardiogram and blood pressure was monitored continuously with digital plethysmography. In 10 patients (protocol 1), we used forearm plethysmography to assess forearm blood flow, from which we calculated forearm vascular resistance by performing venous occlusions during and after obstructive episodes. In an additional four subjects, we used simultaneous Doppler and B-mode images of the brachial artery to measure blood velocity and arterial diameter, from which we calculated brachial flow continuously during spontaneous apneas (protocol 2). In protocol 1, forearm vascular resistance increased 71% after apnea termination (29.3 ± 15.4 to 49.8 ± 26.5 resistance units, P < 0.05) with all patients showing an increase in resistance. In protocol 2, brachial resistance increased at apnea termination in all subjects (219.8 ± 22.2 to 358.3 ± 46.1 mmHg · l-1 · min; P = 0.01). We conclude that termination of obstructive apneas is associated with peripheral vasoconstriction.

forearm blood flow; vasoconstriction; upper airway obstructions


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