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Haemodynamic effects of non-invasive ventilation in patients with obesity-hypoventilation syndrome.
MedLine Citation:
PMID:  22897169     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
SUMMARY AT A GLANCE: The haemodynamic effects of non-invasive ventilation (NIV) have not been investigated in patients with obesity-hypoventilation syndrome (OHS). Right ventricular overload is frequent found in patients with severe OHS. This study has shown that NIV for six months had a beneficial effect on the haemodynamic status of these patients. ABSTRACT: Background and objective:  Although it has been reported that pulmonary hypertension (PH) is more frequent in patients with obesity-hypoventilation syndrome (OHS) than in patients with "pure" obstructive sleep apnoea syndrome, little is known about the haemodynamic repercussions of this entity. The aim was to describe the haemodynamic status, as assessed by echocardiography and six-minute walk test (6MWT), of patients with a newly diagnosed, most severe form of OHS, and to evaluate the impact of non-invasive ventilation (NIV) in these patients. Methods:  A prospective, descriptive, single-centre follow-up study was conducted. At baseline, patients underwent echocardiography, spirometry, static lung volume measurement, 6MWT, overnight pulse-oximetry and polygraphic recording. Changes in echocardiography and 6MWT were assessed after six months of NIV. Right ventricular overload (RVO) was defined on the basis of right ventricular dilatation, hypokinesis, paradoxical septal motion and/or PH. Results:  Thirty patients (20 women; mean age 69±11 years) were tested. The percentage of patients with RVO did not change significantly after NIV (43.3% to 41.6%; P= 0.24). In patients with RVO at diagnosis, pulmonary artery systolic pressure (PSAP) decreased significantly at six months (58±11 to 44±12 mmHg; P=0.014) and mean distance on 6MWT increased from 350±110 to 426±78 m (P=0.006), without significant changes in body mass index. Conclusions:  RVO is a frequent finding in patients with the most severe form of OHS. Treatment with NIV is associated with a decrease in PASP and an increase in the distance covered during the 6MWT. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Authors:
Olalla Castro-Añón; Rafael Golpe; Luis A Pérez-de-Llano; María Jesús López González; Edgar Escalona Velasquez; Ruth Pérez Fernández; Ana Testa Fernández; Arturo González Quintela
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Affiliation:
Respiratory Division and Sleep Disorders Unit Cardiology Service, Hospital Lucus Augusti, Lugo, Department of Internal Medicine, University of Santiago of Compostela, Santiago de Compostela, Spain.
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