Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 6/2017

27.02.2017 | Miscellaneous

Pulmonary hypertension and echocardiogram parameters in obstructive sleep apnea

verfasst von: H. T. Wong, K. H. Chee, A. W. Chong

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Obstructive sleep apnea (OSA) is a growing health hazard in the United States and worldwide. OSA is now recognized as a disorder with systemic manifestations and its association with obesity and adverse cardiovascular consequences. There is increasing evidence that OSA may be associated with systemic hypertension and an increased incidence of stroke, heart failure, myocardial infarction, and arrhythmias. Less information is available about the association between OSA and pulmonary hypertension (PH). We therefore conduct this study to look at the prevalence of the pulmonary hypertension in obstructive sleep apnea patient and to identify risk factors leading to pulmonary hypertension among OSA patient. We studied and analyzed all OSA patient confirmed by polysomnograph in the year 2015. Twenty-five patients with OSA were included in this study with prevalence of pulmonary hypertension of 16%. Univariate analysis of various factors revealed a statistically significant association between having the lowest SpO2 of <70% and pulmonary hypertension (p = 0.016). There were no statistically significant associations between age, gender, smoking status, hypertension, body mass index (BMI), or apnea–hypopnea index (AHI) with occurrence of pulmonary hypertension. AHI is not a good predictor for pulmonary hypertension. The real value of using AHI to predict the health risk of OSA is doubtful. We recommend routine echocardiogram among OSA patient. The objective information in the echocardiogram provides evidence for counseling of patient with disease of OSA and hence hopefully can improve compliance of patient to treatment especially usage of CPAP.
Literatur
1.
Zurück zum Zitat Lopez-Jimenez F, Kuniyoshi FH, Gami A, Somers VK (2008) Obstructive sleep apnea: implications for cardiac and vascular disease. Chest J 133(3):793–804CrossRef Lopez-Jimenez F, Kuniyoshi FH, Gami A, Somers VK (2008) Obstructive sleep apnea: implications for cardiac and vascular disease. Chest J 133(3):793–804CrossRef
2.
Zurück zum Zitat Kamil MA, Teng CL, Hassan SA (2007) Snoring and breathing pauses during sleep in the Malaysian population. Respirology 12(3):375–380CrossRefPubMed Kamil MA, Teng CL, Hassan SA (2007) Snoring and breathing pauses during sleep in the Malaysian population. Respirology 12(3):375–380CrossRefPubMed
3.
Zurück zum Zitat Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, Othman I, Ishak AI (2010) Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening. Traffic Inj Prev 11(6):594–599CrossRefPubMed Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, Othman I, Ishak AI (2010) Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening. Traffic Inj Prev 11(6):594–599CrossRefPubMed
4.
Zurück zum Zitat Puvanendran K, Goh KL (1998) From snoring to sleep apnea in a Singapore population. Sleep Res Online SRO 2(1):11–14 Puvanendran K, Goh KL (1998) From snoring to sleep apnea in a Singapore population. Sleep Res Online SRO 2(1):11–14
5.
Zurück zum Zitat McNicholas WT (2007) Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome. Am J Physiol Regul Integr Comp Physiol 293(4):R1666–R1670CrossRefPubMed McNicholas WT (2007) Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome. Am J Physiol Regul Integr Comp Physiol 293(4):R1666–R1670CrossRefPubMed
6.
Zurück zum Zitat Minai OA, Ricaurte B, Kaw R, Hammel J, Mansour M, McCarthy K, Golish JA, Stoller JK (2009) Frequency and impact of pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am J Cardiol 104(9):1300–1306CrossRefPubMed Minai OA, Ricaurte B, Kaw R, Hammel J, Mansour M, McCarthy K, Golish JA, Stoller JK (2009) Frequency and impact of pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am J Cardiol 104(9):1300–1306CrossRefPubMed
7.
Zurück zum Zitat Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban JP (2000) Pulmonary arterial hypertension in patients with sleep apnoea syndrome. Thorax 55(11):934–939CrossRefPubMedPubMedCentral Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban JP (2000) Pulmonary arterial hypertension in patients with sleep apnoea syndrome. Thorax 55(11):934–939CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Yamakawa H, Shiomi T, Sasanabe R, Hasegawa R, Ootake K, Banno K, Wakayama H, Katada M, Kobayashi T (2002) Pulmonary hypertension in patients with severe obstructive sleep apnea. Psychiatry Clin Neurosci 56(3):311–312CrossRefPubMed Yamakawa H, Shiomi T, Sasanabe R, Hasegawa R, Ootake K, Banno K, Wakayama H, Katada M, Kobayashi T (2002) Pulmonary hypertension in patients with severe obstructive sleep apnea. Psychiatry Clin Neurosci 56(3):311–312CrossRefPubMed
9.
Zurück zum Zitat Podszus T, Bauer W, Mayer J, Penzel T, Peter JH, Von Wichert P (1986) Sleep apnea and pulmonary hypertension. Klin Wochenschr 64(3):131–134CrossRefPubMed Podszus T, Bauer W, Mayer J, Penzel T, Peter JH, Von Wichert P (1986) Sleep apnea and pulmonary hypertension. Klin Wochenschr 64(3):131–134CrossRefPubMed
10.
Zurück zum Zitat Alchanatis M, Tourkohoriti G, Kakouros S, Kosmas E, Podaras S, Jordanoglou JB (2001) Daytime pulmonary hypertension in patients with obstructive sleep apnea. Respiration 68(6):566–572CrossRefPubMed Alchanatis M, Tourkohoriti G, Kakouros S, Kosmas E, Podaras S, Jordanoglou JB (2001) Daytime pulmonary hypertension in patients with obstructive sleep apnea. Respiration 68(6):566–572CrossRefPubMed
11.
Zurück zum Zitat Weitzenblum E, Krieger J, Apprill M, Vallée E, Ehrhart M, Ratomaharo J, Oswald M, Kurtz D (1988) Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis 138(2):345–349CrossRefPubMed Weitzenblum E, Krieger J, Apprill M, Vallée E, Ehrhart M, Ratomaharo J, Oswald M, Kurtz D (1988) Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis 138(2):345–349CrossRefPubMed
12.
Zurück zum Zitat Chaouat A, Weitzenblum E, Krieger J, Oswald M, Kessler R (1996) Pulmonary hemodynamics in the obstructive sleep apnea syndrome: results in 220 consecutive patients. Chest J 109(2):380–386CrossRef Chaouat A, Weitzenblum E, Krieger J, Oswald M, Kessler R (1996) Pulmonary hemodynamics in the obstructive sleep apnea syndrome: results in 220 consecutive patients. Chest J 109(2):380–386CrossRef
13.
Zurück zum Zitat Sanner BM, Doberauer C, Konermann M, Sturm A, Zidek W (1997) Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med 157(21):2483–2487CrossRefPubMed Sanner BM, Doberauer C, Konermann M, Sturm A, Zidek W (1997) Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med 157(21):2483–2487CrossRefPubMed
14.
Zurück zum Zitat Krieger J, Sforza E, Apprill M, Lampert E, Weitzenblum E, Ratomaharo J (1989) Pulmonary hypertension, hypoxemia, and hypercapnia in obstructive sleep apnea patients. CHEST J 96(4):729–737CrossRef Krieger J, Sforza E, Apprill M, Lampert E, Weitzenblum E, Ratomaharo J (1989) Pulmonary hypertension, hypoxemia, and hypercapnia in obstructive sleep apnea patients. CHEST J 96(4):729–737CrossRef
15.
Zurück zum Zitat Laks L, Lehrhaft B, Grunstein RR, Sullivan CE (1995) Pulmonary hypertension in obstructive sleep apnoea. Eur Respir J 8(4):537–541PubMed Laks L, Lehrhaft B, Grunstein RR, Sullivan CE (1995) Pulmonary hypertension in obstructive sleep apnoea. Eur Respir J 8(4):537–541PubMed
16.
Zurück zum Zitat Sajkov D, Wang T, Saunders NA, Bune AJ, Neill AM, Mcevoy RD (1999) Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med 159(5):1518–1526CrossRefPubMed Sajkov D, Wang T, Saunders NA, Bune AJ, Neill AM, Mcevoy RD (1999) Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med 159(5):1518–1526CrossRefPubMed
17.
Zurück zum Zitat Abou Shehata ME, El-Desoky ME, Maaty AE, Abd-ElMaksoud AM, Suliman LA (2013) Pulmonary hypertension in obstructive sleep apnea hypopnea syndrome. Egypt J Chest Dis Tuberc 62(3):459–465CrossRef Abou Shehata ME, El-Desoky ME, Maaty AE, Abd-ElMaksoud AM, Suliman LA (2013) Pulmonary hypertension in obstructive sleep apnea hypopnea syndrome. Egypt J Chest Dis Tuberc 62(3):459–465CrossRef
18.
Zurück zum Zitat Arias MA, García-Río F, Alonso-Fernández A, Martínez I, Villamor J (2006) Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure. Eur Heart J 27(9):1106–1113CrossRefPubMed Arias MA, García-Río F, Alonso-Fernández A, Martínez I, Villamor J (2006) Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure. Eur Heart J 27(9):1106–1113CrossRefPubMed
19.
Zurück zum Zitat Fletcher EC, Schaaf JW, Miller J, Fletcher JG (1987) Long-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease 1–3. Am Rev Respir Dis 135(3):525–533PubMed Fletcher EC, Schaaf JW, Miller J, Fletcher JG (1987) Long-term cardiopulmonary sequelae in patients with sleep apnea and chronic lung disease 1–3. Am Rev Respir Dis 135(3):525–533PubMed
20.
Zurück zum Zitat Kessler R, Chaouat A, Weitzenblum E, Oswald M, Ehrhart M, Apprill M, Krieger J (1996) Pulmonary hypertension in the obstructive sleep apnoea syndrome: prevalence, causes and therapeutic consequences. Eur Respir J 9(4):787–794CrossRefPubMed Kessler R, Chaouat A, Weitzenblum E, Oswald M, Ehrhart M, Apprill M, Krieger J (1996) Pulmonary hypertension in the obstructive sleep apnoea syndrome: prevalence, causes and therapeutic consequences. Eur Respir J 9(4):787–794CrossRefPubMed
21.
Zurück zum Zitat Kulkas A, Tiihonen P, Julkunen P, Mervaala E, Töyräs J (2013) Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea–hypopnea index. Med Biol Eng Comp 51(6):697–708CrossRef Kulkas A, Tiihonen P, Julkunen P, Mervaala E, Töyräs J (2013) Novel parameters indicate significant differences in severity of obstructive sleep apnea with patients having similar apnea–hypopnea index. Med Biol Eng Comp 51(6):697–708CrossRef
22.
Zurück zum Zitat Muraja-Murro A, Kulkas A, Hiltunen M, Kupari S, Hukkanen T, Tiihonen P, Mervaala E, Töyräs J (2013) The severity of individual obstruction events is related to increased mortality rate in severe obstructive sleep apnea. J Sleep Res 22(6):663–669CrossRefPubMed Muraja-Murro A, Kulkas A, Hiltunen M, Kupari S, Hukkanen T, Tiihonen P, Mervaala E, Töyräs J (2013) The severity of individual obstruction events is related to increased mortality rate in severe obstructive sleep apnea. J Sleep Res 22(6):663–669CrossRefPubMed
23.
Zurück zum Zitat Noda A, Okada T, Yasuma F, Nakashima N, Yokota M (1995) Cardiac hypertrophy in obstructive sleep apnea syndrome. Chest 107(6):1538–1544CrossRefPubMed Noda A, Okada T, Yasuma F, Nakashima N, Yokota M (1995) Cardiac hypertrophy in obstructive sleep apnea syndrome. Chest 107(6):1538–1544CrossRefPubMed
24.
Zurück zum Zitat Zamarrón C, Valdés Cuadrado L, Álvarez-Sala R (2013) Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome. Pulm Med Zamarrón C, Valdés Cuadrado L, Álvarez-Sala R (2013) Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome. Pulm Med
25.
Zurück zum Zitat Ge X, Han F, Huang Y, Zhang Y, Yang T, Bai C, Guo X (2013) Is obstructive sleep apnea associated with cardiovascular and all-cause mortality? PLoS One 8(7):e69432CrossRefPubMedPubMedCentral Ge X, Han F, Huang Y, Zhang Y, Yang T, Bai C, Guo X (2013) Is obstructive sleep apnea associated with cardiovascular and all-cause mortality? PLoS One 8(7):e69432CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Butt M, Dwivedi G, Shantsila A, Khair OA, Lip GY (2012) Left ventricular systolic and diastolic function in obstructive sleep apnea impact of continuous positive airway pressure therapy. Circ Heart Fail 5(2):226–233CrossRefPubMed Butt M, Dwivedi G, Shantsila A, Khair OA, Lip GY (2012) Left ventricular systolic and diastolic function in obstructive sleep apnea impact of continuous positive airway pressure therapy. Circ Heart Fail 5(2):226–233CrossRefPubMed
27.
Zurück zum Zitat Usui Y, Takata Y, Inoue Y, Tomiyama H, Kurohane S, Hashimura Y, Kato K, Saruhara H, Asano K, Shiina K, Yamashina A (2013) Severe obstructive sleep apnea impairs left ventricular diastolic function in non-obese men. Sleep Med 14(2):155–159CrossRefPubMed Usui Y, Takata Y, Inoue Y, Tomiyama H, Kurohane S, Hashimura Y, Kato K, Saruhara H, Asano K, Shiina K, Yamashina A (2013) Severe obstructive sleep apnea impairs left ventricular diastolic function in non-obese men. Sleep Med 14(2):155–159CrossRefPubMed
28.
Zurück zum Zitat Wachter R, Lüthje L, Klemmstein D, Lüers C, Stahrenberg R, Edelmann F, Holzendorf V, Hasenfuß G, Andreas S, Pieske B (2013) Impact of obstructive sleep apnoea on diastolic function. Eur Respir J 41(2):376–383CrossRefPubMed Wachter R, Lüthje L, Klemmstein D, Lüers C, Stahrenberg R, Edelmann F, Holzendorf V, Hasenfuß G, Andreas S, Pieske B (2013) Impact of obstructive sleep apnoea on diastolic function. Eur Respir J 41(2):376–383CrossRefPubMed
29.
Zurück zum Zitat Meier M, Andreas S (2012) Mechanisms of cardiovascular co-morbidity in patients with obstructive sleep apnoea syndrome. Pneumologie, Stuttgart, pp 650–657 Meier M, Andreas S (2012) Mechanisms of cardiovascular co-morbidity in patients with obstructive sleep apnoea syndrome. Pneumologie, Stuttgart, pp 650–657
30.
Zurück zum Zitat Murri M, García-Delgado R, Alcázar-Ramírez J, Fernández-Ramos A, Alcaide J, Cardona F, Tinahones FJ (2011) Effect of CPAP on oxidative stress and circulating progenitor cell levels in sleep patients with apnea–hypopnea syndrome. Respir Care 56(11):1830–1836CrossRefPubMed Murri M, García-Delgado R, Alcázar-Ramírez J, Fernández-Ramos A, Alcaide J, Cardona F, Tinahones FJ (2011) Effect of CPAP on oxidative stress and circulating progenitor cell levels in sleep patients with apnea–hypopnea syndrome. Respir Care 56(11):1830–1836CrossRefPubMed
31.
Zurück zum Zitat Kim SM, Cho KI, Kwon JH, Lee HG, Kim TI (2012) Impact of obstructive sleep apnea on left atrial functional and structural remodeling beyond obesity. J Cardiol 60(6):475–483CrossRefPubMed Kim SM, Cho KI, Kwon JH, Lee HG, Kim TI (2012) Impact of obstructive sleep apnea on left atrial functional and structural remodeling beyond obesity. J Cardiol 60(6):475–483CrossRefPubMed
32.
Zurück zum Zitat Cho KI, Kwon JH, Kim SM, Park TJ, Lee HG, Kim TI (2012) Impact of obstructive sleep apnea on the global myocardial performance beyond obesity. Echocardiography 29(9):1071–1780CrossRefPubMed Cho KI, Kwon JH, Kim SM, Park TJ, Lee HG, Kim TI (2012) Impact of obstructive sleep apnea on the global myocardial performance beyond obesity. Echocardiography 29(9):1071–1780CrossRefPubMed
33.
Zurück zum Zitat Danica LP, Krotin M, Zdravkovic M, Soldatovic I, Zdravkovic D, Brajkovic M, Gardijan V, Saric J, Pokrajac R, Lovic D, Stevanovic P (2014) Early left ventricular systolic and diastolic dysfunction in patients with newly diagnosed obstructive sleep apnoea and normal left ventricular ejection fraction. Sci World J. doi:10.1155/2014/898746 Danica LP, Krotin M, Zdravkovic M, Soldatovic I, Zdravkovic D, Brajkovic M, Gardijan V, Saric J, Pokrajac R, Lovic D, Stevanovic P (2014) Early left ventricular systolic and diastolic dysfunction in patients with newly diagnosed obstructive sleep apnoea and normal left ventricular ejection fraction. Sci World J. doi:10.​1155/​2014/​898746
Metadaten
Titel
Pulmonary hypertension and echocardiogram parameters in obstructive sleep apnea
verfasst von
H. T. Wong
K. H. Chee
A. W. Chong
Publikationsdatum
27.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2017
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-017-4491-1

Weitere Artikel der Ausgabe 6/2017

European Archives of Oto-Rhino-Laryngology 6/2017 Zur Ausgabe

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Eingreifen von Umstehenden rettet vor Erstickungstod

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.