cad a22 4500 551414367 20190223051154.0 cr unu---uuuuu 181214e20190201xx s 000 0 eng 10.1183/13993003.01854-2018 doi (ZORA)oai:www.zora.uzh.ch:159293 610 ddc 30487209 pmid Effects of short-term CPAP withdrawal on cerebral vascular reactivity measured by BOLD MRI in OSA: a randomised controlled trial [Elektronische Daten] [Sira Thiel, Franziska Lettau, Protazy Rejmer, Cristina Rossi, Sarah R Haile, Esther I Schwarz, Anna S Stöberl, Noriane A Sievi, Andreas Boss, Anton S Becker, Sebastian Winklhofer, John R Stradling, Malcolm Kohler] closedAccess eu-repo Impaired cerebral vascular reactivity (CVR) increases long-term stroke risk. Obstructive sleep apnoea (OSA) is associated with peripheral vascular dysfunction and vascular events. The aim of this trial was to evaluate the effect of continuous positive airway pressure (CPAP) withdrawal on CVR. 41 OSA patients (88% male, mean age 57±10 yrs.) were randomised to subtherapeutic, or continuation of therapeutic, CPAP. At baseline, and after two weeks, patients underwent a sleep study and magnetic resonance imaging (MRI). CVR was estimated by quantifying the blood oxygen level dependent (BOLD MRI) response to breathing stimuli. OSA did recur in the subtherapeutic-CPAP group (mean treatment effect apnoea-hypopnoea-index [95%CI] +38.0 [+24.2/+52.0] events·h, p<0.001) but remained controlled in the therapeutic group. Although there was a significant increase in blood pressure upon CPAP withdrawal (mean treatment effect [95%CI] +9.37 [+1.36 to 17.39] mmHg, p=0.023), there was no significant effect of CPAP withdrawal on CVR assessed BOLD MRI under either, hyperoxic or hypercapnic conditions. Short-term CPAP withdrawal did not result in statistically significant different changes of CVR assessed by functional MRI despite recurrence of OSA. We thus conclude that unlike peripheral endothelial function, CVR is not affected by short- term CPAP withdrawal. Clinic for Diagnostic and Interventional Radiology zora Clinic for Neuroradiology zora Epidemiology, Biostatistics and Prevention Institute (EBPI) zora Clinic for Pneumology zora Thiel Sira joint author Lettau Franziska joint author Rejmer Protazy joint author Rossi Cristina joint author Haile Sarah R. joint author Schwarz Esther I. joint author Stöberl Anna S. joint author Sievi Noriane A. joint author Boss Andreas joint author Becker Anton S. joint author Winklhofer Sebastian joint author Stradling John R. joint author Kohler Malcolm joint author European Respiratory Journal 53(2):1801854 https://www.zora.uzh.ch/159293 text/html WWW-Backlink auf das Repository 1 Journal Article PeerReviewed zora ZORA 856 40 https://www.zora.uzh.ch/159293 text/html WWW-Backlink auf das Repository ZORA 700 1- Thiel Sira joint author ZORA 700 1- Lettau Franziska joint author ZORA 700 1- Rejmer Protazy joint author ZORA 700 1- Rossi Cristina joint author ZORA 700 1- Haile Sarah R. joint author ZORA 700 1- Schwarz Esther I. joint author ZORA 700 1- Stöberl Anna S. joint author ZORA 700 1- Sievi Noriane A. joint author ZORA 700 1- Boss Andreas joint author ZORA 700 1- Becker Anton S. joint author ZORA 700 1- Winklhofer Sebastian joint author ZORA 700 1- Stradling John R. joint author ZORA 700 1- Kohler Malcolm joint author ZORA 773 0- European Respiratory Journal 53(2):1801854 BK010053 XK010053 XK010000 ZORA ZORA ZORA Journal Article closedAccess