Document Detail

Pulmonary hemodynamics in obstructive sleep apnea: frequency and causes of pulmonary hypertension.
MedLine Citation:
PMID:  14565689     Owner:  NLM     Status:  MEDLINE    
The association between nocturnal apneas and transient pulmonary hypertension (PHT) has been well documented. However, there is controversy over the frequency and pathophysiological mechanisms of daytime pulmonary hypertension in patients with obstructive sleep apnea (OSAS). The present study sought to evaluate frequency and mechanisms of pulmonary hypertension in patients with OSAS. It included 49 consecutive patients with polysomnographically proven OSAS without pathological lung function testing. All patients performed daytime measurements of pulmonary hemodynamics at rest and during exercise (50-75W). Six patients (12%) had resting PHT mean pulmonary of artery pressure (PAPM) of >20 mmHg), whereas 39 patients (80%) showed PHT during exercise (PAPM >30 mmHg). Multiple regression analysis revealed 3 independent contributing factors for mean pulmonary artery pressure during exercise (PAPMmax): body mass index, age and total lung capacity % of predicted. Twenty-five of the 39 patients with pathologically high PAPMmax (64%) showed elevated pulmonary capillary wedge pressures (PCWPmax > 20 mmHg), whereas no patient had elevated pulmonary vascular resistance (PVRmax > 120 dynes x s x cm(-5)). In conclusion, daytime PHT during exercise is frequently seen in patients with OSAS and normal lung function testing and is mainly caused by abnormally high PCWP, whereas PVR seems to play a minor role.
M Hetzel; M Kochs; N Marx; H Woehrle; I Mobarak; V Hombach; J Hetzel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lung     Volume:  181     ISSN:  0341-2040     ISO Abbreviation:  Lung     Publication Date:  2003  
Date Detail:
Created Date:  2003-10-20     Completed Date:  2003-11-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7701875     Medline TA:  Lung     Country:  United States    
Other Details:
Languages:  eng     Pagination:  157-66     Citation Subset:  IM    
Department of Internal Medicine II, University Hospital, Ulm University, Germany.
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MeSH Terms
Exercise Test
Hypertension, Pulmonary / physiopathology*
Middle Aged
Pulmonary Artery / physiopathology
Pulmonary Wedge Pressure
Regression Analysis
Respiratory Function Tests
Sleep Apnea, Obstructive / physiopathology*

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