Title Information
Title
Association of Pulse Transit Time in Pregnancy with Obstructive Sleep Apnea Status, Blood Pressure, and Gestational Hypertensive Disorders
Type of Resource
text
Name: Personal
Name Part
Link, Brittany Noelle
Role
Role Term: Text
creator
Name: Personal
Name Part
Bourjeily, Ghada
Role
Role Term: Text
Advisor
Name: Personal
Name Part
Bublitz, Margaret
Role
Role Term: Text
Reader
Name: Personal
Name Part
Morgan, Jeffrey
Role
Role Term: Text
Reader
Name: Corporate
Name Part
Brown University. Department of Molecular Pharmacology, Physiology and Biotechnology
Role
Role Term: Text
sponsor
Origin Information
Copyright Date
2017
Physical Description
Extent
viii, 88 p.
digitalOrigin
born digital
Note: thesis
Thesis (Sc. M.)--Brown University, 2017
Genre (aat)
theses
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.
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00965831")
Topic
Hypertension
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01075044")
Topic
Preeclampsia
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01075102")
Topic
Pregnancy
Subject
Topic
Obstructive Sleep Apnea
Subject
Topic
Pulse Transit Time
Subject
Topic
Gestational Hypertension
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01120834")
Topic
Sleep apnea syndromes
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01120836")
Topic
Sleep apnea syndromes--Treatment--Equipment and supplies
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01120844")
Topic
Sleep disorders
Subject
Topic
Sleep-disordered breathing
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01120847")
Topic
Sleep disorders--Diagnosis
Language
Language Term (ISO639-2B)
English
Record Information
Record Content Source (marcorg)
RPB
Record Creation Date (encoding="iso8601")
20170616
Identifier: DOI
10.7301/Z0BV7F2Q
Access Condition: rights statement (href="http://rightsstatements.org/vocab/InC/1.0/")
In Copyright
Access Condition: restriction on access
Collection is open for research.