Document Detail


Non invasive mechanical ventilation in Obesity Hypoventilation Syndrome: are multimodal therapeutic strategies disease essential?
MedLine Citation:
PMID:  23231633     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We read with interest the article by Castro-Añón et al. We strongly agree that hemodynamic features of NIV in OHS are poorly investigated in literature. In this study, the authors did not specify how long the hypoxemia was present and the eventual oxygen therapy. The initial response of pulmonary vascular bed to hypoxemia is a vasoconstriction at the pulmonary arteriolar and capillary level. In OHS, a chronic hypoxemia determines pulmonary artery remodelling over time. The decrease of PASP after treatment of NIV may depend on the amount and duration of hypoxemia. Several nonrandomized studies reported the improvement of PH with NIV. The prevalence of OHS and its severity are linearly related to BMI. In this study BMI variation was not an endpoint. However, the condition of obesity is a risk factor for the development of cardiomyopathy characterized by eccentric ventricular hypertrophy and diastolic heart failure.(4) This chronic elevated left ventricular filling pressure associated with left ventricular failure can lead to secondary PH. Weight loss improves left ventricular contractility, diastolic function and endothelial function.
Authors:
Antonio M Esquinas; Angelo Petroianni
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Publication Detail:
Type:  LETTER     Date:  2012-12-12
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-12     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 Author. Respirology © 2012 Asian Pacific Society of Respirology.
Affiliation:
Respiratory Diseases Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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