Imperial College London
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ProfessorMaryMorrell

Faculty of Medicine, National Heart & Lung Institute

Professor of Sleep & Respiratory Physiology
 
 
 
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Contact

 

m.morrell

 
 
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Location

 

Room 103ASir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Carlisle:2017:10.14814/phy2.12956,
author = {Carlisle, T and Ward, NR and Atalla, A and Cowie, MR and Simonds, AK and Morrell, MJ},
doi = {10.14814/phy2.12956},
journal = {Physiological Reports},
title = {Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure},
url = {http://dx.doi.org/10.14814/phy2.12956},
volume = {5},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The increased prevalence of obstructive sleep apnea (OSA) in congestive heart failure (CHF) may be associated with rostral fluid shift. We investigated the effect of overnight rostral fluid shift on pharyngeal collapsibility (Pcrit), pharyngeal caliber (APmean), and apneahypopnea index (AHI) in CHF patients. Twentythree optimally treated systolic CHF patients were studied. Neck circumference was measured immediately prior to sleep in the evening and immediately after waking in the morning as a marker of rostral fluid shift. Pcrit was measured during sleep, early and late in the night. APmean was measured using acoustic reflection at the same times as neck circumference measurements. 15/23 CHF patients experienced an overnight increase in neck circumference; overall neck circumference significantly increased overnight (mean±SD, evening: 41.7 ± 3.2 cm; morning: 42.3 ± 3.1 cm; P = 0.03). Pcrit increased significantly overnight (earlynight: −3.8 ± 3.3 cmH2O; latenight: −2.6 ± 3.0 cmH2O; P = 0.03) and APmean decreased (evening: 4.2 ± 1.3 cm2; morning: 3.7 ± 1.3 cm2; P = 0.006). The total AHI correlated with neck circumference (r = 0.4; P = 0.04) and Pcrit (r = 0.5; P = 0.01). APmean correlated with neck circumference (r = −0.47; P = 0.02). There was no significant change in AHI between the first and second half of the night (firsthalf: 12.9 ± 12.4/h; secondhalf: 13.7 ± 13.3/h; P = 0.6). Overnight rostral fluid shift was associated with increased pharyngeal collapsibility and decreased pharyngeal caliber during sleep in CHF patients. Rostral fluid shift may be an important mechanism of OSA in this patient group.
AU  - Carlisle,T
AU  - Ward,NR
AU  - Atalla,A
AU  - Cowie,MR
AU  - Simonds,AK
AU  - Morrell,MJ
DO  - 10.14814/phy2.12956
PY  - 2017///
SN  - 2051-817X
TI  - Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure
T2  - Physiological Reports
UR  - http://dx.doi.org/10.14814/phy2.12956
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000392243200010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/49927
VL  - 5
ER  -
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