Frequency and Impact of Pulmonary Hypertension in Patients With Obstructive Sleep Apnea Syndrome
The correlates and consequences of pulmonary hypertension (PH) associated with obstructive sleep apnea (OSA) are poorly understood. Patients undergoing pulmonary artery catheterization within 6 months of an overnight polysomnography showing OSA were included in the present analysis. A total of 83 pa...
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| Veröffentlicht in: | The American journal of cardiology 2009-11, Vol.104 (9), p.1300-1306 |
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| creator | Minai, Omar A., MD Ricaurte, Basma, MD Kaw, Roop, MD Hammel, Jeff, MS Mansour, Mary, MD McCarthy, Kevin, RPSGT Golish, Joseph A., MD Stoller, James K., MD |
| description | The correlates and consequences of pulmonary hypertension (PH) associated with obstructive sleep apnea (OSA) are poorly understood. Patients undergoing pulmonary artery catheterization within 6 months of an overnight polysomnography showing OSA were included in the present analysis. A total of 83 patients with complete data were analyzed (no PH, n = 25 [30%]; PH, 58 [70%]; of these, 18 had a pulmonary capillary wedge pressure of |
| doi_str_mv | 10.1016/j.amjcard.2009.06.048 |
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Patients undergoing pulmonary artery catheterization within 6 months of an overnight polysomnography showing OSA were included in the present analysis. A total of 83 patients with complete data were analyzed (no PH, n = 25 [30%]; PH, 58 [70%]; of these, 18 had a pulmonary capillary wedge pressure of <15 mm Hg). No significant differences were observed between the PH and no PH groups regarding age or apnea-hypopnea index. The correlates of PH were elevated right ventricular systolic pressure (p <0.001), body mass index (p = 0.026), female gender (p = 0.01), nocturnal desaturation (82% vs 18%), and forced vital capacity <70% (p = 0.04) on univariate analysis and female gender (p = 0.03), age <49 years (p = 0.02), body mass index of ≥26 kg/m2 (p = 0.08), and right ventricular systolic pressure of ≥30 mm Hg (p <0.001) on multivariate analysis. Patients with PH had a lower 6-minute walk distance (285.5 ± 122 m vs 343 ± 213 m, p = 0.4). The survival rate at 1, 4, and 8 years for patients with PH was 93%, 75%, and 43% compared to 100%, 90%, and 76% for patients without PH, respectively. Patients with severe PH (n = 27; 33%) had more nocturnal desaturation (p = 0.045), worse pulmonary hemodynamics, and greater mortality (37%) than the groups with mild or moderate PH (16%) or no PH (16%). In conclusion, our results have shown that, although generally mild to moderate, severe PH can occur in patients with OSA. Female gender, younger age, obesity, and nocturnal desaturation were associated with PH. PH can cause functional limitations and increased mortality in patients with OSA.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2009.06.048</identifier><identifier>PMID: 19840581</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Body Mass Index ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Exercise Test ; Female ; Heart Ventricles - diagnostic imaging ; Humans ; Hypertension, Pulmonary - epidemiology ; Hypertension, Pulmonary - physiopathology ; Intubation ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Oxygen - blood ; Pneumology ; Polysomnography ; Pulmonary arteries ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Pulmonary Wedge Pressure - physiology ; Respiratory system : syndromes and miscellaneous diseases ; Severity of Illness Index ; Sex Factors ; Sleep apnea ; Sleep Apnea, Obstructive - epidemiology ; Survival analysis ; Systole - physiology ; Ultrasonography ; Ventricular Function, Right - physiology</subject><ispartof>The American journal of cardiology, 2009-11, Vol.104 (9), p.1300-1306</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Nov 1, 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-70c6948216caa8980b192bd0906fc26e26dfe1fd8aedb882bbdb517290428c973</citedby><cites>FETCH-LOGICAL-c476t-70c6948216caa8980b192bd0906fc26e26dfe1fd8aedb882bbdb517290428c973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914909012806$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22058490$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19840581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Minai, Omar A., MD</creatorcontrib><creatorcontrib>Ricaurte, Basma, MD</creatorcontrib><creatorcontrib>Kaw, Roop, MD</creatorcontrib><creatorcontrib>Hammel, Jeff, MS</creatorcontrib><creatorcontrib>Mansour, Mary, MD</creatorcontrib><creatorcontrib>McCarthy, Kevin, RPSGT</creatorcontrib><creatorcontrib>Golish, Joseph A., MD</creatorcontrib><creatorcontrib>Stoller, James K., MD</creatorcontrib><title>Frequency and Impact of Pulmonary Hypertension in Patients With Obstructive Sleep Apnea Syndrome</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The correlates and consequences of pulmonary hypertension (PH) associated with obstructive sleep apnea (OSA) are poorly understood. Patients undergoing pulmonary artery catheterization within 6 months of an overnight polysomnography showing OSA were included in the present analysis. A total of 83 patients with complete data were analyzed (no PH, n = 25 [30%]; PH, 58 [70%]; of these, 18 had a pulmonary capillary wedge pressure of <15 mm Hg). No significant differences were observed between the PH and no PH groups regarding age or apnea-hypopnea index. The correlates of PH were elevated right ventricular systolic pressure (p <0.001), body mass index (p = 0.026), female gender (p = 0.01), nocturnal desaturation (82% vs 18%), and forced vital capacity <70% (p = 0.04) on univariate analysis and female gender (p = 0.03), age <49 years (p = 0.02), body mass index of ≥26 kg/m2 (p = 0.08), and right ventricular systolic pressure of ≥30 mm Hg (p <0.001) on multivariate analysis. Patients with PH had a lower 6-minute walk distance (285.5 ± 122 m vs 343 ± 213 m, p = 0.4). The survival rate at 1, 4, and 8 years for patients with PH was 93%, 75%, and 43% compared to 100%, 90%, and 76% for patients without PH, respectively. Patients with severe PH (n = 27; 33%) had more nocturnal desaturation (p = 0.045), worse pulmonary hemodynamics, and greater mortality (37%) than the groups with mild or moderate PH (16%) or no PH (16%). In conclusion, our results have shown that, although generally mild to moderate, severe PH can occur in patients with OSA. Female gender, younger age, obesity, and nocturnal desaturation were associated with PH. PH can cause functional limitations and increased mortality in patients with OSA.</description><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - epidemiology</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Intubation</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Oxygen - blood</subject><subject>Pneumology</subject><subject>Polysomnography</subject><subject>Pulmonary arteries</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Pulmonary Wedge Pressure - physiology</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Survival analysis</subject><subject>Systole - physiology</subject><subject>Ultrasonography</subject><subject>Ventricular Function, Right - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk9r3DAQxU1paTZpP0KLKJSevB3JtixdWkJo_kAggW3pUZWlMdXWlh3JDvjbV8uaFHLpSQz85mnmvcmydxS2FCj_vN_qfm90sFsGILfAt1CKF9mGilrmVNLiZbYBAJZLWsqT7DTGfSoprfjr7IRKUUIl6Cb7dRnwYUZvFqK9JTf9qM1Ehpbcz10_eB0Wcr2MGCb00Q2eOE_u9eTQT5H8dNNvctfEKcxmco9Idh3iSM5Hj5rsFm_D0OOb7FWru4hv1_cs-3H57fvFdX57d3VzcX6bm7LmU16D4bIUjHKjtZACGipZY0ECbw3jyLhtkbZWaLSNEKxpbFPRmkkomTCyLs6yT0fdMQxpoTip3kWDXac9DnNUdVGCLCsuEvnhGbkf5uDTcIoVUNRVUcoEVUfIhCHGgK0ag-uTHYqCOgSg9moNQB0CUMBVCiD1vV_F56ZH-69rdTwBH1dAR6O7NmhvXHziGEtUKSFxX48cJtMeHQYVTbLdoHUBzaTs4P47ypdnCqZz3qVP_-CC8WlpqiJToHaHazkcS_KcMgG8-Avy_7sD</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Minai, Omar A., MD</creator><creator>Ricaurte, Basma, MD</creator><creator>Kaw, Roop, MD</creator><creator>Hammel, Jeff, MS</creator><creator>Mansour, Mary, MD</creator><creator>McCarthy, Kevin, RPSGT</creator><creator>Golish, Joseph A., MD</creator><creator>Stoller, James K., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20091101</creationdate><title>Frequency and Impact of Pulmonary Hypertension in Patients With Obstructive Sleep Apnea Syndrome</title><author>Minai, Omar A., MD ; Ricaurte, Basma, MD ; Kaw, Roop, MD ; Hammel, Jeff, MS ; Mansour, Mary, MD ; McCarthy, Kevin, RPSGT ; Golish, Joseph A., MD ; Stoller, James K., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-70c6948216caa8980b192bd0906fc26e26dfe1fd8aedb882bbdb517290428c973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - epidemiology</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Intubation</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Oxygen - blood</topic><topic>Pneumology</topic><topic>Polysomnography</topic><topic>Pulmonary arteries</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Pulmonary Wedge Pressure - physiology</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - epidemiology</topic><topic>Survival analysis</topic><topic>Systole - physiology</topic><topic>Ultrasonography</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minai, Omar A., MD</creatorcontrib><creatorcontrib>Ricaurte, Basma, MD</creatorcontrib><creatorcontrib>Kaw, Roop, MD</creatorcontrib><creatorcontrib>Hammel, Jeff, MS</creatorcontrib><creatorcontrib>Mansour, Mary, MD</creatorcontrib><creatorcontrib>McCarthy, Kevin, RPSGT</creatorcontrib><creatorcontrib>Golish, Joseph A., MD</creatorcontrib><creatorcontrib>Stoller, James K., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minai, Omar A., MD</au><au>Ricaurte, Basma, MD</au><au>Kaw, Roop, MD</au><au>Hammel, Jeff, MS</au><au>Mansour, Mary, MD</au><au>McCarthy, Kevin, RPSGT</au><au>Golish, Joseph A., MD</au><au>Stoller, James K., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and Impact of Pulmonary Hypertension in Patients With Obstructive Sleep Apnea Syndrome</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>104</volume><issue>9</issue><spage>1300</spage><epage>1306</epage><pages>1300-1306</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The correlates and consequences of pulmonary hypertension (PH) associated with obstructive sleep apnea (OSA) are poorly understood. Patients undergoing pulmonary artery catheterization within 6 months of an overnight polysomnography showing OSA were included in the present analysis. A total of 83 patients with complete data were analyzed (no PH, n = 25 [30%]; PH, 58 [70%]; of these, 18 had a pulmonary capillary wedge pressure of <15 mm Hg). No significant differences were observed between the PH and no PH groups regarding age or apnea-hypopnea index. The correlates of PH were elevated right ventricular systolic pressure (p <0.001), body mass index (p = 0.026), female gender (p = 0.01), nocturnal desaturation (82% vs 18%), and forced vital capacity <70% (p = 0.04) on univariate analysis and female gender (p = 0.03), age <49 years (p = 0.02), body mass index of ≥26 kg/m2 (p = 0.08), and right ventricular systolic pressure of ≥30 mm Hg (p <0.001) on multivariate analysis. Patients with PH had a lower 6-minute walk distance (285.5 ± 122 m vs 343 ± 213 m, p = 0.4). The survival rate at 1, 4, and 8 years for patients with PH was 93%, 75%, and 43% compared to 100%, 90%, and 76% for patients without PH, respectively. Patients with severe PH (n = 27; 33%) had more nocturnal desaturation (p = 0.045), worse pulmonary hemodynamics, and greater mortality (37%) than the groups with mild or moderate PH (16%) or no PH (16%). In conclusion, our results have shown that, although generally mild to moderate, severe PH can occur in patients with OSA. Female gender, younger age, obesity, and nocturnal desaturation were associated with PH. PH can cause functional limitations and increased mortality in patients with OSA.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19840581</pmid><doi>10.1016/j.amjcard.2009.06.048</doi><tpages>7</tpages></addata></record> |
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| subjects | Biological and medical sciences Body Mass Index Cardiology Cardiology. Vascular system Cardiovascular Exercise Test Female Heart Ventricles - diagnostic imaging Humans Hypertension, Pulmonary - epidemiology Hypertension, Pulmonary - physiopathology Intubation Medical sciences Middle Aged Mortality Multivariate Analysis Oxygen - blood Pneumology Polysomnography Pulmonary arteries Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Pulmonary Wedge Pressure - physiology Respiratory system : syndromes and miscellaneous diseases Severity of Illness Index Sex Factors Sleep apnea Sleep Apnea, Obstructive - epidemiology Survival analysis Systole - physiology Ultrasonography Ventricular Function, Right - physiology |
| title | Frequency and Impact of Pulmonary Hypertension in Patients With Obstructive Sleep Apnea Syndrome |
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