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Variation of respiratory and pulse events in multiple system atrophy
Yasuyoshi Ohshima1, Satoshi Hokari1, Asuka Nagai1
1Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata 951-8510, Japan.
Patients with multiple system atrophy (MSA) show a blunted pulse response to breathing issues during sleep, indicated by a low pulse event index (PEI) to oxyhemoglobin desaturation index (ODI) ratio, suggesting a worse prognosis.
Area of Science:
- Neurology
- Sleep Medicine
- Cardiology
Background:
- Multiple system atrophy (MSA) is associated with a high risk of sudden death, particularly during sleep.
- A blunted cardiac response to sleep-related breathing disorders is suspected in MSA patients.
- Existing evidence on the cardiac response to nocturnal respiratory events in MSA is limited and speculative.
Purpose of the Study:
- To investigate the relationship between nocturnal respiratory events and cardiac response in patients with MSA.
- To determine if the pulse event index (PEI) to oxyhemoglobin desaturation index (ODI) ratio is a useful indicator in MSA.
Main Methods:
- Retrospective analysis of overnight oximetry data from 26 patients with MSA.
- Calculation of the 4% oxyhemoglobin desaturation index (ODI) and the 6-beats-per-minute (bpm) pulse event index (PEI).
- Analysis of the PEI/ODI ratio and its trend over time in a subset of patients.
Main Results:
- The median PEI/ODI ratio was 0.91, indicating a blunted pulse response.
- Three patients with suspected sudden death exhibited low PEI/ODI ratios.
- A longitudinal decrease in the PEI/ODI ratio was observed in seven patients.
Conclusions:
- A low PEI/ODI ratio in MSA patients may signify a poorer prognosis.
- The blunted pulse response to nocturnal respiratory events warrants further investigation.
- Prospective studies are needed to confirm these findings and explore the significance of longitudinal PEI/ODI ratio changes.
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