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首页> 外文学位 >Abnormalities in cardiovascular autonomic function: Independent effects of sleep-disordered breathing and impaired glucose metabolism.
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Abnormalities in cardiovascular autonomic function: Independent effects of sleep-disordered breathing and impaired glucose metabolism.

机译：心血管自主功能异常：睡眠呼吸障碍和葡萄糖代谢受损的独立影响。

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摘要

Dysfunction of the autonomic nervous system (ANS) has been linked to cardiovascular disease, stroke, sleep apnea, hypertension, and type 2 diabetes. The early identification of impairment in ANS function could effectively reduce the associated mortality and morbidity. As most of aforementioned disorders are intertwined, a screening tool with reasonable sensitivity and specificity would represent an important clinical advancement. In this report, we present methods for noninvasive assessment of cardiovascular autonomic dysfunction resulting from chronic exposure to sleep disordered-breathing (SDB) and impaired glucose metabolism (IGM), based on spectral indices derived from heart rate variability (HRV) and pulse transit time (PTT) variability (PTTV). HRV and PTTV are easily derived from the electrocardiogram (ECG) and photo-plethysmography (PLETH), both measurements being largely available in all clinical settings and relatively cheap.;The present study consists of two distinctive phases, which are discussed in sequence in this report. In phase I of the study, HRV indices and a new baroreflex sensitivity (BRS) measure BRSPTT were calculated from overnight polysomnography (PSG) and compared across four quadrants of disorder conditions: non-SDB-non-IGM, isolated SDB, isolated IGM, and mixed SDB+IGM. Sleep/wake stage, which has been previously identified as an important modulating factor, was adjusted by a novel weighted-sum method. In phase II of the study, to further unravel the tangled SDB-IGM effects among patients with mixed SDB and IGM, stage-specific BRSPTT were derived from PSGs of patients who went through a 2-month period of continuous positive airway pressure (CPAP) therapy. The association between BRSPTT and IGM, before and after CPAP treatment, was assessed using a fixed effects mixed model.
机译：自主神经系统（ANS）的功能障碍与心血管疾病，中风，睡眠呼吸暂停，高血压和2型糖尿病有关。及早发现ANS功能障碍可有效降低相关的死亡率和发病率。由于上述大多数疾病相互交织，具有合理敏感性和特异性的筛选工具将代表重要的临床进展。在本报告中，我们基于心率变异性（HRV）和脉搏传播时间得出的频谱指数，提出了无创评估心血管疾病自主神经功能障碍的方法，这些疾病是由于长期暴露于睡眠呼吸障碍（SDB）和葡萄糖代谢受损（IGM）而引起的（PTT）变异性（PTTV）。 HRV和PTTV可以很容易地从心电图（ECG）和光体积描记法（PLETH）推导出来，这两种测量在所有临床环境中都可以大量使用并且相对便宜。本研究包括两个不同的阶段，在此依次进行讨论。报告。在研究的第一阶段，通过隔夜多导睡眠图（PSG）计算了HRV指数和新的压力反射敏感性（BRS）量度BRSPTT，并比较了四类疾病状况：非SDB-非IMG，孤立SDB，孤立IGM，以及混合的SDB + IGM。睡眠/唤醒阶段，以前已被确定为重要的调节因子，可通过新型加权和方法进行调整。在研究的第二阶段，为了进一步揭示混合SDB和IGM患者之间SDB-IGM的纠结，特定阶段的BRSPTT来自经历2个月持续气道正压通气（CPAP）的患者的PSG治疗。使用固定效应混合模型评估CPAP治疗前后BRSPTT与IGM之间的关联。

著录项

  • 作者

    Wang, Wenli.;

  • 作者单位

    University of Southern California.;

  • 授予单位 University of Southern California.;
  • 学科 Biology Biostatistics.;Biology Physiology.;Engineering Biomedical.
  • 学位 Ph.D.
  • 年度 2011
  • 页码 187 p.
  • 总页数 187
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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