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Biomedical subjects

Jason H Mateika

Publications and source records attributed to Jason H Mateika.

5 recordsLinked to original sources

Chemoreflex control of ventilation is altered during wakefulness in humans with OSA.

We hypothesized that patients with obstructive sleep apnea (OSA) have a different awake ventilatory response to carbon dioxide above and below eupnea compared with normal. Eight male subjects with OSA and control subjects matched for gender, race, age, height and weight voluntarily hyperventilated during wakefulness to reduce the partial pressure of carbon dioxide (PET(CO2)) below 25 mmHg. Subjects were then switched into a rebreathing bag containing a normocapnic (42 mmHg) hypoxic [partial pressure of end tidal oxygen (PET(O2))=50 mmHg (H50)] or hyperoxic [PET(O2)=140 mmHg (H140)] gas mixture. During the trial PET(CO2) increased while PET(O2) was maintained at a constant level. The point at which ventilation and PET(CO2) increased linearly was considered to be the carbon dioxide ventilatory recruitment threshold (VRT(CO2)). Measurements of ventilation and its components (i.e. tidal volume and breathing frequency) were made below this threshold and the slope of the minute ventilation; tidal volume or breathing frequency response above the threshold was determined. Four trials for a given oxygen level were completed. The PET(CO2) that demarcated the VRT(CO2) was increased (H(50)=43.43+/-0.92 vs. 41.05+/-0.67; H(140)=47.65+/-0.80 vs. 45.28+/-0.75), as were measures of ventilation below the threshold (H(50)=18.50+/-2.11 vs. 13.44+/-1.43; H(140)=19.66+/-2.71 vs. 10.83+/-1.24) in the OSA subjects compared with control. In contrast the OSA and control subjects did not respond differently to changes in PET(CO2) above the threshold. We conclude that the PET(CO2) that delineates the VRT(CO2) and ventilation below this threshold is elevated in subjects with OSA.

Adult↗

Internal representations underlying respiration during object manipulation.

We examined the presence of anticipatory control and the resulting interactions of the respiratory and motor systems during discrete object manipulation. In response to an auditory signal, subjects reached forward, grasped, and lifted an instrumented object weighing 150 or 1000 g while the breathing pattern, fingertip forces, and movements were measured. Following every block of five lifts, the object was removed from sight and replaced with the same or an alternate mass. Thus, the object's weight was predictable during the last lift of each block and unpredictable during the first lift after the transition. When the object's weight was predictable, the force application was faster and inspiratory duration and the tidal volume were reduced for the breath associated with the lift for 1000-g compared to 150-g lifts. Following the transition, when the object's weight was unpredictable, the force application reflected the weight of the object during the previous lift while the respiratory output, regardless of the preceding weight, resembled that used for 1000-g lifts. Additionally, inspiratory duration was significantly correlated with the reach duration in three of the four unpredictable lifting conditions. We conclude that these system-specific anticipatory alterations may arise from a common internal representation that was formed through past manipulatory weight experience.

Adult↗

Respiratory-related activation of human abdominal muscles during exercise.

We tested the hypothesis that abdominal muscles are active during the expiratory phase of the respiratory cycle during exercise. Electromyographic (EMG) activities of external oblique and rectus abdominis muscles were recorded during incremental exercise to exhaustion and during 30 min of constant work rate exercise at an intensity of 85 % of the peak oxygen consumption rate (V(O(2))). High amplitude intramuscular EMG activities of both abdominal muscles could be evoked with postural manoeuvres in all subjects. During cycling, respiratory-related activity of the external obliques was evoked in four of seven subjects, whereas rectus abdominis activity was observed in six of the seven subjects. We measured only the activity that was confined exclusively to the expiratory phase of the respiratory cycle. Expiratory activity of both muscles increased with exercise intensity, although peak values averaged only 10-20 or 20-40 % of the peak activity (obtained during maximal, voluntary expiratory efforts) for the external oblique and rectus abdominis muscles, respectively. To estimate how much of the recorded abdominal muscle activity was supporting leg movements during exercise, we compared the activity at the very end of incremental exercise to that recorded during the first five respiratory cycles after the abrupt cessation of exercise, when ventilation was still very high. Although external oblique activity was reduced after exercise stopped, clear expiratory activity remained. Rectus abdominis activity remained high after exercise cessation, showing a gradual decline that approximated the decline in ventilation. During constant work rate exercise, EMG activities increased to 40-50 and 5-10 % of peak in rectus and external oblique muscles, respectively, and then plateaued for the remainder of the bout in spite of a continual upward drift in (V(O(2))) and pulmonary ventilation. Linear regression analysis showed that the rise in respiratory-related expiratory muscle activity during progressive intensity exercise was significantly correlated with ventilation, although weakly. In constant work rate exercise, expiratory EMG activities increased, but the changes were highly variable and did not change as a function of exercise time, even though ventilation drifted significantly with time. These experiments suggest that abdominal muscles play a role in regulating the ventilatory response to progressive intensity bicycle exercise, although some of the observed activity may support postural adjustments or limb movements. The contribution of abdominal muscles to ventilation during constant work rate exercise is variable, and expiratory activity does not 'drift' significantly with time.

Abdominal Muscles↗

Effects of lung volume and chemoreceptor activity on blood pressure and R-R interval during the Valsalva maneuver.

STUDY OBJECTIVES: The purpose of the present investigation was to examine the effect of lung volume and inspiration of 100% oxygen on blood pressure and R-R interval responses during the Valsalva maneuver. DESIGN AND PARTICIPANTS: Fourteen healthy subjects completed eight Valsalva maneuvers. Four of the maneuvers were completed after inspiring to total lung capacity while the remaining maneuvers were completed at end-expiratory lung volume. Two maneuvers completed at a given lung volume were performed under hyperoxic conditions while the remaining maneuvers were completed under normoxic conditions. RESULTS: Overall, a significant increase in blood pressure and decrease in R-R interval occurred throughout phases I-IV of the Valsalva maneuvers that were initiated from end-expiratory lung volume as compared to total lung capacity. These changes were accompanied by a concomitant increase in baroreflex sensitivity during phase IV. Furthermore, independent of lung volume the baroreflex response was attenuated under hyperoxic conditions. CONCLUSIONS: We conclude that the lung volume that exists prior to the onset of the maneuver alters the blood pressure and R-R interval response during phases I-IV of the Valsalva maneuver. Furthermore, we suggest that these responses are mediated in part by changes in chemoreceptor activity since the baroreflex was reset and the sensitivity was reduced under hyperoxic conditions. Given these findings, we recommend that lung volume be controlled when patients are completing a Valsalva maneuver to obtain reliable and reproducible measures of blood pressure, R-R interval duration and baroreflex sensitivity.

Administration, Inhalation↗

Arterial stiffness increases during obstructive sleep apneas.

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) appears to be an independent risk factor for diurnal systemic hypertension, but the specific biologic markers for this association have not been well established. Increased arterial stiffness is an important measure of increased left ventricular load and a predictor of cardiovascular morbidity and may precede the onset of systemic hypertension in humans. However, arterial stiffness has not been measured in association with obstructive apneas in patients with OSA, nor related to systemic blood pressure (BP) activity in this setting. Our objective was to test the hypothesis that arterial stiffness may be utilized as a sensitive measure of arterial vasomotor perturbation during obstructive events in patients with OSA, by demonstrating that (1) arterial stiffness increases acutely in association with obstructive apnea and hypopnea, and that (2) such increased stiffness may occur in the absence of acute BP increase. DESIGN: Prospective, cross-sectional. SETTING: A tertiary-care university-based sleep and ventilatory disorders center. PATIENTS: Forty-four normo- and hypertensive adult patients (11 women, 33 men) with polysomnographically diagnosed moderate to severe OSA. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Beat-to-beat BP was recorded from the radial artery by applanation tonometry during nocturnal polysomnography. Arterial augmentation index (AAI), a measure of arterial stiffness, was calculated as the ratio of augmented systolic BP (SBP) to pulse pressure and expressed as a percentage for the following conditions: awake, the first 10 ("early apnea") and last 10 ("late apnea") cardiac cycles of obstructive events, and the first 15 cardiac cycles following apnea termination ("post apnea"). Mean AAI (+/-SD) for the group was significantly increased during NREM sleep from early apnea to late apnea (12.02 +/- 2.70% vs 13.35 +/- 3.54%, p<0.05, ANOVA). During REM (analyzed in 20 patients), MI again significantly increased from early apnea to late apnea (11.75 +/- 2.81% vs 13.43 +/- 4.97%). Conversely, neither mean SBP nor mean arterial BP was significantly changed from early apnea to late apnea in NREM (SBP 130 +/- 14 mmHg vs 129 +/- 14 mmHg) or REM (SBP 128 +/- 22 mmHg vs 127 +/- 21 mmHg). CONCLUSIONS: Arterial stiffness increases acutely during obstructive apneas in both NREM and REM sleep, in the absence of measurable BP change. These data suggest that arterial stiffness may be a sensitive measure of acute arterial vasomotor perturbation in this setting and may have implications concerning cardiovascular sequelae in patients with OSA.

Adult↗