Almeneessier Aljohara S, Nashwan Samar Z, Al-Shamiri Mostafa Q, Pandi-Perumal Seithikurippu R, BaHammam Ahmed S
Department of Family Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Thorac Dis. 2017 Mar;9(3):779-788. doi: 10.21037/jtd.2017.03.21.
One important cardiovascular morbidity that is associated with obesity hypoventilation syndrome (OHS) is the development of pulmonary hypertension (PH). However, few studies have assessed PH in OHS patients. Therefore, we prospectively assessed the prevalence of PH in a large sample of OHS patients.
In this prospective observational study, all consecutive OHS patients referred to the sleep disorders clinic during the study period were included. All patients underwent overnight polysomnography (PSG), spirometry, arterial blood samples and thyroid tests. Transthoracic echocardiography was performed for patients who agreed to participate in the study. PH was defined as systolic pulmonary artery pressure (SPAP) >40 mmHg.
Echocardiographic data were available for 77 patients with a mean age of 60.5±11.7 years, a BMI of 43.2±10.4 kg/m, and an Epworth Sleepiness Scale (ESS) score of 11.4±5.5. SPAP was >40 mmHg in 53 patients (68.8%), with a mean SPAP of 64.1±17.1 mmHg. There were no differences between the OHS patients with PH and those with normal PAP in terms of age, BMI, presenting symptoms, comorbidities, arterial blood gasses (ABG), and spirometric and PSG parameters. Approximately 71.4% of women and 61.9% of men with OHS also had PH. SPAP was >40-55 mmHg in 19 (24.7%) patients (18 women), >55-70 mmHg in 15 (19.5%) patients (6 women) and >70 mmHg in 19 (24.7%) patients (16 women). Severe PH (SPAP >70 mmHg) was diagnosed in 28.6% of the women and 14.3% of the men.
PH is very common among patients with OHS who have been referred to sleep disorders clinics. PH should be considered in the regular clinical assessment of all patients with OHS.
与肥胖低通气综合征（OHS）相关的一种重要心血管疾病是肺动脉高压（PH）的发生。然而，很少有研究评估OHS患者中的PH情况。因此，我们前瞻性地评估了一大群OHS患者中PH的患病率。
在这项前瞻性观察研究中，纳入了研究期间转诊至睡眠障碍门诊的所有连续OHS患者。所有患者均接受了夜间多导睡眠图（PSG）、肺功能测定、动脉血样本采集和甲状腺检查。同意参与研究的患者进行了经胸超声心动图检查。PH定义为收缩期肺动脉压（SPAP）>40 mmHg。
77例患者有超声心动图数据，平均年龄60.5±11.7岁，体重指数（BMI）为43.2±10.4 kg/m²，爱泼沃斯嗜睡量表（ESS）评分为11.4±5.5。53例患者（68.8%）的SPAP>40 mmHg，平均SPAP为64.1±17.1 mmHg。在年龄、BMI、出现的症状、合并症、动脉血气（ABG）以及肺功能测定和PSG参数方面，OHS合并PH的患者与PAP正常的患者之间无差异。约71.4%的OHS女性和61.9%的OHS男性也患有PH。19例（24.7%）患者（18名女性）的SPAP>40 - 55 mmHg，15例（19.5%）患者（6名女性）的SPAP>55 - 70 mmHg，19例（24.7%）患者（16名女性）的SPAP>70 mmHg。28.6%的女性和14.3%的男性被诊断为重度PH（SPAP>70 mmHg）。
PH在转诊至睡眠障碍门诊的OHS患者中非常常见。在所有OHS患者的常规临床评估中都应考虑到PH。
