Mendoza AVM, Paniagua SR, Kornhauser AC, Wrobel K, Malacara HJM, Nava EL, Chi-Lem G

Language: Spanish
References: 53
Page: 147-158
PDF size: 124.61 Kb.

ABSTRACT

The present prospective study longitudinal, experimental and controlled, was carried out with the purpose of analyzing the sympathetic nerve activity in the patient with OSA associated to systemic arterial hypertension.
28 subjects were studied: Group I: Constituted by 14 patients with OSA (habitual snorer with more than 5 apnea obstructive/h), Group II: for 14 subject habitual snorers (when the subject or his wife accept that snorers 5 days a week but present less than 5 apnea obstructive/h).
To all the patients were carried out complete clinical history, were made breathing functional test, prolactin, and plasmatic catecholamines and urine for chromatography liquid of high pressure, determines the pressure of the lung artery for echocardiography Doppler, as well as arterial saturation of oxygen. The patient to be hospitalized by the realization of the mentioned studies, studies that were made before and after oxygen.
The administration of I oxygen was carried out through mask to 40% from 22 o’clock until the 6 hrs. daily, in the own home of patients for the lapse of 4 weeks. Results: In the group I: patient with OSA with average, IMC 25.3 ± 1.0 was made studies polisomnographic demonstrating an apnea index ± hipopnea inside the inferior limits of 18.7 ± 10.4, the breathing functional tests showed basal restrictive pattern 70.3 ± 4.7 and later to the oxygen administration the functional tests remained inside of normal parameters breathing 77.0 ± 1.8 being appreciated a p ‹ 0.05. In the group II the breathing tests remained before inside normal parameters and after the oxygen administration. In the group I the systolic pressure of the lung artery determined by echocardiography, it was elevated in their basal determination 30.4 ± 9.7 for later to the administration of oxygen 26.5 ± 8.6 remained inside normal parameters, existing a p ‹ 0.03, in the group II the systolic pressure of the lung artery remained before inside normal parameters and after the treatment of oxygen. In the group I the plasmatic prolactin was high basal level 36.7 ± 5.8 and later to treatment with oxygen 7.9 ± 3.4 remained inside normal parameters being appreciated a p ‹ 0.001, in the group II the plasmatic prolactina remained before inside the normal parameters and later to oxigenotherapy, in the group I the determination of catecholamines plasmatic and urine for liquid chromatography, it was high at basal level, for later to treatment with oxygen remained inside the normal parameters existing a p ‹ 0.001, in the group II the determination of catecholamines urine for liquid chromatography of high pressure remained before inside normal parameters and later to treatment with oxygen. Conclusions: In the patient with light OSA associated to light systemic arterial hypertension, increment exist in the sympathetic activity at basal level what sustains the probability of an deficiency neuromodulation of the activity dopaminergic and be part of the physiopathology of the hypertension in the patient with OSA and the action of the oxygen is probably through of a modulation inhibitory of the sympathetic activity: a) chronic breathing stress exists in the patient with OSA b) probably secondary hyperprolactinemia exists to breathing stress c) deficiency of the system central and outlying dopaminergic exists.

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