Wong H T, Chee K H, Chong A W
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2601-2606. doi: 10.1007/s00405-017-4491-1. Epub 2017 Feb 27.
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 SpO 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.
阻塞性睡眠呼吸暂停(OSA)在美国乃至全球都是日益严重的健康威胁。OSA目前被认为是一种具有全身表现的疾病,且与肥胖及不良心血管后果相关。越来越多的证据表明,OSA可能与系统性高血压以及中风、心力衰竭、心肌梗死和心律失常的发病率增加有关。关于OSA与肺动脉高压(PH)之间关联的信息较少。因此,我们开展这项研究,以观察阻塞性睡眠呼吸暂停患者中肺动脉高压的患病率,并确定OSA患者中导致肺动脉高压的危险因素。我们研究并分析了2015年通过多导睡眠图确诊的所有OSA患者。本研究纳入了25例OSA患者,肺动脉高压患病率为16%。对各种因素的单因素分析显示,最低血氧饱和度<70%与肺动脉高压之间存在统计学显著关联(p = 0.016)。年龄、性别、吸烟状况、高血压、体重指数(BMI)或呼吸暂停低通气指数(AHI)与肺动脉高压的发生之间无统计学显著关联。AHI并非肺动脉高压的良好预测指标。使用AHI预测OSA健康风险的实际价值值得怀疑。我们建议对OSA患者进行常规超声心动图检查。超声心动图中的客观信息为OSA患者的咨询提供了依据,因此有望提高患者对治疗的依从性,尤其是持续气道正压通气(CPAP)的使用。