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Ventilatory responses to progressive hypercapnia were analyzed in the normocapnic and hypercapnic obstructive sleep apnea patients (OSA). The rebreathing hypercapnic and hypoxic tests were performed using the computerized equipment (Lungtest, MES), according to Read's method. The ventilatory response to hypoxia was impaired in all OSA patients. Concerning the hypercapnic ventilatory response, there were no differences between the OSA patients with normal end-tidal PCO2 and controls. Nine moderately hypercapnic OSA patients showed a right shift with a normal slope of the regression curve describing the relationship between the end-tidal PCO2 and minute ventilation. In contrast, three severely hypercapnic OSA patients showed a right shift with a decreased slope of this regression curve. We conclude that awake OSA patients who developed hypercapnic ventilatory insufficiency showed an impaired hypercapnic defense reaction.
Our previous studies indicated the presence of a respiratory effector of carotid baroreceptor activation: the respiratory resistance. A brief decrease in respiratory resistance was observed in response to carotid baroreceptor activation. In the course of aging we found a decrease in the heart response to carotid baroreceptor activation and disappearance of the respiratory response. The aim of the present study was to determine whether the circadian variations of baroreflex sensitivity, as related to aging, are attributable to changes in cardiovascular and respiratory control in the elderly. We evaluated the cardiac responses and the reflex changes of the respiratory resistance to carotid baroreceptor activation every two hours in: 12 healthy male subjects aged 20-38 years, 6 male subjects aged 20-38 years and 6 male subjects aged 70-80 years. Two neck-chambers were used to produce a brief suction, applied to carotid sinus regions, activating the carotid baroreceptor. We found that the circadian courses of the cardiac and respiratory responses to baroreceptor activation were shifted down in the older groups of subjects, as compared with the younger ones. In the 50-80-year old subjects no respiratory response to carotid baroreceptor stimulation was observed. We further found that the impaired carotid baroreflex control of heart function and of respiratory resistance, observed in older subjects, reached a minimum between 3.00 and 7.00 hours in the morning. We conclude that this period is a risk time for the occurrence of cardiac disorders, especially for cardiac arrhythmias, and it is also the time of impaired reflex control of respiratory resistance.
Several lines of evidence suggest that physical exercise not only influences the development of muscles, cardiovascular and respiratory systems, but also exerts a significant influence on the central nervous system. We examined the influence of strength and endurance training on cognitive performance in 33 healthy elderly volunteers (women, mean age 63.5 ±4.5 yr) over a 3-month period of supervised training program. A control group consisted of 8 age-matched (mean age 66.3 ±4.6) healthy volunteers who did not participate in any exercise training program. To evaluate the cognitive performance in our subjects we used two tests: face/name association test and Stroop test. The tests were applied shortly before and immediately after the training program. In the experimental group, a significant improvement in the association test performance, on average, from 71.6 ±7.3% to 79.7 ±7.2% (P<0.0001) was observed over the 3-month training period. There were no changes in the Stroop test results over the same time. Likewise, there were no changes in the control groups. Our data demonstrate that the training regime that is strictly followed over a relatively short period of time may improve the performance in associative memory tasks in elderly subjects. The study supports the notion that physical exercise influences cognitive performance and extend this notion to be valid for healthy elderly subjects.
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