Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Clinical Investigations

Daytime Pulmonary Hypertension in Patients with Obstructive Sleep Apnea

The Effect of Continuous Positive Airway Pressure on Pulmonary Hemodynamics

Alchanatis M.a · Tourkohoriti G.a · Kakouros S.b · Kosmas E.a · Podaras S.a · Jordanoglou J.B.a

Author affiliations

aPulmonary Department, Athens University Medical School and bCardiology Department, ‘Sotiria’ Hospital for Chest Diseases, Athens, Greece

Related Articles for ""

Respiration 2001;68:566–572

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: December 21, 2001
Issue release date: November – December

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

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 (PPA). Methods: Twenty-nine patients aged 51 ± 10 years with OSA and 12 control subjects were studied with pulsed-wave Doppler echocardiography for estimation of PPA before and after 6-month effective treatment with CPAP. Results: A significantly higher mean PPA 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 (PPA ≧ 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/m2, 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 PPA 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.

© 2001 S. Karger AG, Basel


References

  1. Marrone O, Bellia V, Ferrara G, Milone F, Romano L, Salvagio A, Stallone A, Bonsignore G: Transmural pressure measurements: Importance in the assessment of pulmonary hypertension in obstructive sleep apnea. Chest 1989;95:338–342.
  2. Pozdus T: Pulmonary hemodynamics in sleep-related breathing disorders; in Smirne S, Franceschi M, Ferini Strambi L (eds): Sleep and Ageing. Milano, Masson, 1991, pp 122–134
  3. Krieger J, Sforza E, Apprill M, Lampert E, Weitzenblum E, Ratomaharo J: Pulmonary hypertension, hypoxemia and hypercapnia in obstructive sleep apnea patients. Chest 1989;96:729–737.
  4. Laks L, Lehrhaft B, Grunstein RR, Sullivan CE: Pulmonary hypertension in obstructive sleep apnoea. Eur Respir J 1995;8:537–541.
  5. Marrone O, Bonsignore MR, Insalaco G, Bonsignore G: What is the evidence that obstructive sleep apnoea is an important illness ? Monaldi Arch Chest Dis 1998;53:630–639.
  6. Weitzenblum E, Hirth C, Ducolone A, Mirhom R, Rasaholinjanhary J, Ehrhart M: Prognostic value of pulmonary artery pressure in chronic obstructive pulmonary disease. Thorax 1981;36:752–758.
  7. Alchanatis M, Paradellis G, Pini H, Tourkohoriti G, Jordanoglou J: Left ventricular function in patients with obstructive sleep apnoea syndrome before and after treatment with nasal CPAP. Respiration 2000;67:367–371.
  8. Berger M, Haimovitz A, van Tosh A, Berdoff RL, Goldberg E: Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 1985;6:359–365.
  9. Yock PG, Koito H: Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 1984;70:657–662.
  10. Kuida H: Pulmonary hypertension and pulmonary heart disease; in Hurst JW (ed): The Heart: Arteries and Veins. New York, McGraw-Hill Book, 1986, pp 1091–1099.
  11. Saijkov D, Cowie RJ, Bradley JA, Mahar L, McEvoy RD: Validation of new pulsed-wave Doppler echocardiographic techniques for assessment of pulmonary hemodynamics. Chest 1993;103:1348–1353.
  12. Morera J, Hoadley SD, Roland JM, Pasipoularides A, Darragh R, Gaitan G, Pieroni D: Estimation of the ratio of pulmonary to systemic pressure by pulsed-wave Doppler echocardiography for assessment of pulmonary arterial pressures. Am J Cardiol 1989;63:862–866.
    External Resources
  13. Himelman RB, Stulbarg M, Kircher B: Noninvasive evaluation of pulmonary artery pressure during exercise by saline-enhanced Doppler echocardiography in chronic pulmonary disease. Circulation 1989;79:863–871.
    External Resources
  14. Schroeder JS, Motta J, Guilleminault C: Hemodynamic studies in sleep apnea; in Guilleminault C, Dement WC (eds): Sleep Apnea Syndromes. New York, Liss, 1978, pp 177–196.
  15. Chaouat A, Weitzenblum E, Krieger J, Oswald M, Kessler R: Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Chest 1996;109:380–386.
  16. Sanner B, Doberauer C, Konermann M, Sturm A, Zidek W: Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med 1997;157:2483–2487.
  17. Sajkov D, Cowie RJ, Thornton AT, Espinoza HA, McEvoy RD: Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1994;149:416–422.
  18. Sajkov D, Wang T, Saunders NA, Bune AJ, Neill AM, McEvoy RD: Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med 1999;159:1518–1526.
  19. Laaban JP, Cassulto D, Orvoen-Frija E, Iliou MC, Mundler O, Leger D, Oppert JM: Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity. Eur Respir J 1998;11:20–27.
  20. Marrone O, Bomsignore MR: Acute and chronic influences of obstructive sleep apnoea on the pulmonary circulation. Monaldi Arch Chest Dis 1997;52/3:263–267.
  21. Chaouat A, Weitzenblum E, Kessler R, Oswald M, Sforza E, Liegeon MN, Krieger J: Five-year effect of nasal continuous positive airway pressure in obstructive sleep apnoea syndrome. Eur Respir J 1997;10:2578–2582.

Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: December 21, 2001
Issue release date: November – December

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.