Pulmonary hypertension in obstructive sleep apnea hypopnea syndrome

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• 作者：Abou Shehata ME ; Mohamed E. El-Desoky ; Abd El-Razek Maaty ; Amina M. Abd-ElMaksoud ; Lucy A. Suliman
• 关键词：ODI ; oxygen desaturation index ; PH ; pulmonary hypertension ; AHI ; apnea hypopnea index ; mPAP ; mean pulmonary artery pressure ; PASP ; pulmonary artery systolic pressure ; BMI ; body mass index
• 刊名：Egyptian Journal of Chest Diseases and Tuberculosis
• 出版年：July, 2013
• 年：2013
• 卷：62
• 期：3
• 页码：459-465
• 全文大小：372 K

文摘

Background

There has been uncertainty until recently whether OSA, is sufficient to cause persistent daytime pulmonary hypertension and right ventricular dysfunction.

Objectives

The aims of this study, were to investigate whether OSA by itself without any other cardiac or lung disease can lead to pulmonary hypertension, and to assess the effect of CPAP therapy on pulmonary artery pressure.

Subjects and methods

The study was performed on 54 OSA patients. All patients were subjected to thorough history taking including Epworth sleepiness scale and Berlin questionnaire, physical examinations, calculation of BMI, plain chest X-ray pulmonary function tests, polysomnography and echocardiography. Ten patients out of 24 patients of OSA with PH have been treated with CPAP for six months.

Results

Pulmonary hypertension (PH) was present in (44.4%) of OSA patients. There were significantly higher PASP and mPAP in severe OSA patients versus non severe OSA patients. There were significant higher BMI, neck circumference, AHI and ODI in OSA patients with PH compared to OSA patients without PH. Awake SaO₂ and minimum SaO₂ were significantly lower in OSA patients with PH compared to OSA patients without PH. There were significant reduction in both mPAP and PASP after 6 months of CPAP treatment (p = 0.007, 0.005 respectively).

Conclusion

OSA is associated with pulmonary hypertension, improvement of pulmonary hypertension through controlling OSA by CPAP therapy signifies that OSA plays a crucial role in the pathogenesis of pulmonary hypertension.

Recommendations

CPAP therapy should be advised to all OSA patients with pulmonary hypertension.