Description
- Abstract:
- Abstract of “Association of Pulse Transit Time in Pregnancy with Obstructive Sleep Apnea Status, Blood Pressure, and Gestational Hypertensive Disorders,” by Brittany Noelle Link, ScM, Brown University, May 2017 Background: Sleep-disordered breathing (SDB) is characterized by recurrent airflow limitation, hypoxia, and arousals from sleep, and is common in pregnancy. The gold standard for observing airflow limitations during sleep is esophageal pressure monitoring (EPM), an invasive method not routinely used clinically. Instead, airflow limitations that meet the apnea/hypopnea criteria are measured using oronasal airflow sensors and nasal pressure transducers. This method accurately diagnoses obstructive sleep apnea (OSA), but is less accurate than EPM in detecting subtle disease and in populations such as pregnant women. An alternative method is analysis of pulse transit time (PTT), the time it takes blood expelled from the left ventricle to reach a peripheral site. PTT is able to detect airflow limitation, arousals/microarousals, and changes in arterial stiffness. The aims of the study were to assess PTT’s effectiveness in evaluating SDB, examine the correlation of PTT with blood pressure (BP) measurements, and to explore the ability of PTT to predict development of gestational hypertensive disorders. Methods: Pregnant women with obesity and snoring (n=128) underwent overnight in-home sleep testing and electrocardiography in the 1st trimester. The software measured PTT but sleep study was manually scored. Statistical analysis included t-tests, univariate analysis of variance, and Spearman correlations. Results: Average PTT was similar in SDB+ and SDB- women. There was no significant correlation between PTT Drops Index and Apnea Hypopnea Index (AHI) (p=.089, R2=.00082). PTT identified 30 additional women as having SDB compared to AHI and changed disease severity classification. There was a significant negative correlation between Maximum PTT and multiple BP variables, including Average Whole-day Systolic BP (p=.007, r=-.529). PTT values in early in early pregnancy did not discriminate which women would develop gestational hypertensive disorders. Conclusion: PTT measurements likely detect more subtle events than apneas/hypopneas in pregnancy and correlate negatively with nocturnal and diurnal BP measurements. This correlation implies that changes in sympathetic activation that occur with sleep persists into daytime. The inability of PTT to discriminate women at risk for developing hypertensive disorders of pregnancy may mean that control groups are at equally at high risk; however these data may limited by sample size.
- Notes:
- Thesis (Sc. M.)--Brown University, 2017
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Citation
Link, Brittany Noelle,
"Association of Pulse Transit Time in Pregnancy with Obstructive Sleep Apnea Status, Blood Pressure, and Gestational Hypertensive Disorders"
(2017).
Molecular Pharmacology, Physiology, and Biotechnology Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.7301/Z0BV7F2Q
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Molecular Pharmacology, Physiology, and Biotechnology Theses and Dissertations
Theses and Dissertations for the Molecular Pharmacology, Physiology, and Biotechnology department....