Journal Information
Vol. 42. Issue 2.
Pages 92-95 (February 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 2.
Pages 92-95 (February 2006)
Techniques and Procedures
Full text access
Determining Cardiac Output by Carbon Dioxide Rebreathing in Patients With Sleep Apnea-Hypopnea Syndrome
Visits
4127
A. Alonso-Fernándeza,
Corresponding author
aaf_97@hotmail.com

Correspondence: Dr. A. Alonso-Fernández. Marte, 32. 28760 Tres Cantos. Madrid. España
, M.A. Ariasb, F. García-Ríoc
a Servicio de Neumología, Hospital Universitario Son Dureta, Palma de Mallorca, Spain
b Servicio de Cardiología, Complejo Hospitalario de Jaén, Jaén, Spain
c Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

The objective of the present study was to determine the relation between resting cardiac output in patients with sleep apnea-hypopnea syndrome but without arterial hypertension or heart failure as measured indirectly by the carbon dioxide rebreathing method and left ventricular function evaluated by transthoracic echocardiography. We also compared the variability and reproducibility of the measurements obtained by the equilibrium and exponential methods. In patients with sleep apnea-hypopnea syndrome there was a modest but significant association between resting cardiac output and left ventricular shortening fraction (r=0.690; P=.001) and left ventricular ejection fraction (r=0.690; P=.001). In addition, mean (SD) cardiac output obtained by the equilibrium method showed a lower coefficient of variability (0.21 [0.08]) than that of the exponential method (0.16 [0.09]) (P<.01) as well as a narrower reproducibility interval.

Key words:
Cardiac output
Carbon dioxide rebreathing
Stroke volume
Sleep apnea-hypopnea syndrome
Left ventricular function
Variability

El objetivo del presente estudio ha sido relacionar la medida indirecta del gasto cardíaco por reinhalación de anhídrido carbónico en reposo en pacientes con síndrome de apneas-hipopneas durante el sueño sin hipertensión arterial ni insuficiencia cardíaca, con la función ventricular izquierda valorada mediante ecocardiografía transtorácica. También se comparan la variabilidad y la reproducibilidad de las medidas obtenidas por el método del equilibrio y por el método exponencial. En pacientes con síndrome de apneas-hipopneas durante el sueño se evidencia una relación moderada pero significativa del gasto cardíaco en reposo (método de equilibrio) con las fracciones de acortamiento (r = 0,690; p < 0,001) y de eyección del ventrículo izquierdo (r = 0,690; p < 0,001). Además, el gasto cardíaco obtenido por el método de equilibrio mostró un menor coeficiente de variabilidad que por el obtenido por el método exponencial (0,21 ± 0,08 frente a 0,16 ± 0,09; p < 0,01), así como un menor intervalo de reproducibilidad.

Palabras clave:
Gasto cardíaco
Reinhalación de CO2
Volumen sistólico
Síndrome de apneas durante el sueño
Función ventricular izquierda
Variabilidad
Full text is only aviable in PDF
REFERENCES
[1]
JM Marín, SJ Carrizo, E Vicente, AG Agustí.
Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study.
Lancet, 365 (2005), pp. 1046-1053
[2]
J Durán, S Esnaola, R Rubio, A Iztueta.
Obstructive sleep apneahypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.
Am J Respir Crit Care Med, 163 (2001), pp. 685-689
[3]
F García-Río.
El síndrome de apneas del sueño como causa y consecuencia de insuficiencia cardíaca congestiva.
Med Clin (Barc), 116 (2001), pp. 312-314
[4]
NL Jones.
Clinical exercise testing, W.B. Saunders, (1988),
[5]
CR Collier.
Determination of mixed venous CO2 pressures by rebreathing.
J Appl Physiol, 9 (1956), pp. 25-29
[6]
JG Defares.
Determination of PvCO2 from the exponential CO2 rise during rebreathing.
J Appl Physiol, 13 (1958), pp. 159-164
[7]
DJ Sahn, A deMaria, J Kisslo, A Weyman.
Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.
Circulation, 58 (1978), pp. 1072-1083
[8]
MA Quinones, AD Waggoner, LA Reduto, JG Nelson, JB Young, WL Winters Jr, et al.
A new, simplified and accurate method for determining ejection fraction with two-dimensional echocardiography.
Circulation, 64 (1981), pp. 744-753
[9]
JH Auchincloss, R Gilbert, M Kuppinger, D Peppi.
Mixed venous CO2 pressure during exercise.
J Appl Physiol, 48 (1980), pp. 933-938
[10]
JA Franciosa, DO Ragan, SJ Rubenstone.
Validation of the CO2 rebreathing method for measuring cardiac output in patients with hypertension or heart failure.
J Lab Clin Med, 88 (1976), pp. 672-682
[11]
JP Clausen, OA Larsen, J Trap-Jensen.
Cardiac output in middle-aged patients determined with CO2 rebreathing method.
J Appl Physiol, 28 (1970), pp. 337-342
[12]
RD Wigle, PD Hamilton, JO Parker.
Measurement of cardiac output by carbon dioxide rebreathing.
Can J Appl Sport Sci, 4 (1979), pp. 135-139
[13]
K Espersen, EW Jensen, D Rosenborg, JK Thomsen, K Eliasen, NV Olsen, et al.
Comparison of cardiac output measurement techniques: thermodilution, Doppler, CO2-rebreathing and the direct Fick method.
Acta Anaesthesiol Scand, 39 (1995), pp. 245-251
[14]
JH Wilmore, PA Farrell, AC Norton, RW Cote III, EF Coyle, GA Ewy, et al.
An automated, indirect assessment of cardiac output during rest and exercise.
J Appl Physiol, 52 (1982), pp. 1493-1497
[15]
A Alonso, F García Río, M Mediano, JM Pino, D Álvaro, J Gómez de Terreros, et al.
Disminución de la respuesta del gasto cardíaco al ejercicio en pacientes con SAOS.
Arch Bronconeumol, 38 (2002), pp. 21

This study was partially funded by the Fondo de Investigaciones Sanitarias FIS 01/0278 and a PNEUMOMADRID 2000 grant.

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?