Περίληψη:
Background. Limited information exists regarding the development of
pulmonary hypertension in patients with obstructive sleep apnea (OSA) in
the absence of lung and heart comorbidity. Objectives: The aims of this
study were to investigate whether OSA patients without any other cardiac
or lung disease develop pulmonary hypertension, and to assess the effect
of continuous positive airway pressure (CPAP) treatment on pulmonary
artery pressure (P-PA). Methods: Twenty-nine patients aged 51 +/- 10
years with OSA and 12 control subjects were studied with pulsed-wave
Doppler echocardiography for estimation Of P-PA before and after 6-month
effective treatment with CPAP. Results: A significantly higher mean P-PA
was found in OSA patients as compared to control subjects (17.2 +/- 5.2
vs. 12.1 +/- 1.9 mm Hg, p < 0.001). Six out of the 29 OSA patients had
mild pulmonary hypertension (P-PA greater than or equal to 20 mm Hg).
Significant differences were observed between pulmonary hypertensive and
normotensive OSA patients with respect to age (62 +/- 4 vs. 48 +/- 15
years, respectively, p < 0.05), body mass index (41 +/- 7 vs. 32 +/- 4
kg/m(2), p < 0.02) and daytime PaO2 (81 +/- 9 vs. 92 +/- 9 mm Hg, p <
0.05). CPAP treatment was effective in reducing mean PPA in both groups
of pulmonary hypertensive and normotensive OSA patients (decreases in
P-PA from 25.6 +/- 4.0 to 19.5 +/- 1.5 mm Hg, p < 0.001; from 14.9 +/-
2.2 to 11.5 +/- 2.0 mm Hg, respectively, p < 0.001). Conclusions: A
proportion (20.7%) of OSA patients without any other lung or heart
disease and characterized by older age, greater obesity and lower
daytime oxygenation develop mild pulmonary hypertension which has been
partially or completely reversed after 6-month CPAP treatment. In
conclusion, OSA alone constitutes an independent risk factor for the
development of pulmonary hypertension. Copyright(C)2001 S. KargerAG,
Basel.
Συγγραφείς:
Alchanatis, M
Tourkohoriti, G
Kakouros, S
Kosmas, E and
Podaras, S
Jordanoglou, JB
