What does this research mean for the field?

Metabolic syndrome decreases the oscillatory pattern of muscle sympathetic nerve activity and the magnitude of arterial baroreflex control, while comorbid obstructive sleep apnea exacerbates these autonomic dysfunctions and increases the time delay of the baroreflex response. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess whether metabolic syndrome alone and in combination with obstructive sleep apnea impairs the oscillatory pattern of muscle sympathetic nerve activity and lengthens baroreflex response time delay.

January 26, 2013AJP Heart and Circulatory Physiology

Time delay of baroreflex control and oscillatory pattern of sympathetic activity in patients with metabolic syndrome and obstructive sleep apnea

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Why the study?

Does the presence of obstructive sleep apnea in patients with metabolic syndrome impair the oscillatory pattern of MSNA and the time delay of the arterial baroreflex control?

Population

55 participants: 43 patients with metabolic syndrome allocated into MetS + OSA and MetS - OSA, and 12…

Design

Cross-sectional

Authors

ETEdgar Toschi‐DiasUniversidade de São Paulo ITIvani C. TrombettaUniversidade Nove de Julho VSValdo J. Dias da SilvaUniversidade Federal do Triângulo Mineiro

Discussion

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Implication

Comorbid OSA may worsen autonomic dysregulation in MetS; hypothesis-generating and should not yet change practice.

Key Points

To assess whether metabolic syndrome alone and in combination with obstructive sleep apnea impairs the oscillatory pattern of muscle sympathetic nerve activity and lengthens baroreflex response time delay.
Evaluated 43 patients with metabolic syndrome categorized by polysomnography into MetS + OSA (n = 21; apnea-hypopnea index > 15 events/h) and MetS - OSA (n = 22), alongside 12 age-matched healthy controls.
Measured muscle sympathetic nerve activity via microneurography, beat-to-beat blood pressure, and heart rate via electrocardiogram.
Analyzed the oscillatory pattern of sympathetic activity using autoregressive spectral analysis and quantified baroreflex sensitivity and time delay via bivariate autoregressive analysis.
MetS + OSA patients demonstrated a significantly decreased oscillatory pattern of muscle sympathetic nerve activity compared with MetS - OSA (P < 0.01) and controls (P < 0.001), while MetS - OSA also showed lower oscillatory activity than controls (P < 0.01).
Baroreflex sensitivity was significantly lower and response time delay was longer in MetS + OSA compared to MetS - OSA (P < 0.001 and P < 0.01, respectively) and controls (P < 0.001 for both).
MetS - OSA independently impaired autonomic regulation, showing reduced baroreflex sensitivity compared with healthy controls (P < 0.001).

Structured PICO

Does the presence of obstructive sleep apnea in patients with metabolic syndrome impair the oscillatory pattern of MSNA and the time delay of the arterial baroreflex control?

Population

55 participants: 43 patients with metabolic syndrome (MetS) allocated into MetS + OSA (n=21) and MetS - OSA (n=22), and 12 age-paired healthy controls. OSA defined as apnea-hypopnea index > 15 events/h.

Comparator

Healthy controls and MetS patients without OSA

Outcome

Oscillatory pattern of muscle sympathetic nerve activity (MSNA) and time delay of the arterial baroreflex control (ABR) of sympathetic activitysurrogate

Metabolic syndrome decreases the oscillatory pattern of MSNA and ABRMSNA magnitude, and comorbid OSA exacerbates these autonomic dysfunctions while increasing the time delay of the baroreflex response.

Cite This Study

Toschi‐Dias et al. (2013) studied this question.

synapsesocial.com/papers/6a1be133ea84844e355f1c06 https://doi.org/10.1152/ajpheart.00848.2012

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Time delay of baroreflex control and oscillatory pattern of sympathetic activity in patients with metabolic syndrome and obstructive sleep apnea

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Time delay of baroreflex control and oscillatory pattern of sympathetic activity in patients with metabolic syndrome and obstructive sleep apnea

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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