Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial

Masa, Juan F.; Mokhlesi, Babak; Mogollón, María V.; Terreros, F.J. Gómez de; Sánchez-Quiroga, M-Ángeles; Romero, Odile; Caballero-Eraso, Candela; Alonso-Álvarez, María Luz; Ordax-Carbajo, Estrella; Gómez-García, Teresa; González, Mónica; López-Martín, Soledad; Marı́n, José Marı́a; Martí, Sergi; Díaz-Cambriles, Trinidad; Chiner, Eusebi; Egea, Carlos; Barca, Javier; Polo, Francisco José Vázquez; Negrín, Miguel Ángel; Martel–Escobar, María; Barbé, Ferrán; Corral, Jaime

doi:10.1164/rccm.201906-1122oc

Cited by 39 publications

(19 citation statements)

References 55 publications

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“…Worsening of hypoxemia under NIV related to right to left shunt through a patent foramen ovale has been reported [150]. Conversely, NIV, when effective on ABG and nocturnal SpO 2 , has a positive impact on pulmonary hypertension and LVEF [151].…”

Section: Obesity-hypoventilation Syndromementioning

confidence: 99%

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

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Long-term mechanical ventilation is a well-established treatment for chronic hypercapnic respiratory failure (CHRF). It is aimed at improving CHRF-related symptoms, health-related quality of life, survival, and decreasing hospital admissions. In Switzerland, long-term mechanical ventilation has been increasingly used since the 1980s in hospital and home care settings. Over the years, its application has considerably expanded with accumulating evidence of beneficial effects in a broad range of conditions associated with CHRF. Most frequent indications for long-term mechanical ventilation are chronic obstructive pulmonary disease, obesity hypoventilation syndrome, neuromuscular and chest wall diseases. In the current consensus document, the Special Interest Group of the Swiss Society of Pulmonology reviews the most recent scientific literature on long-term mechanical ventilation and provides recommendations adapted to the particular setting of the Swiss healthcare system with a focus on the practice of non-invasive and invasive home ventilation in adults.

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Section: Obesity-hypoventilation Syndromementioning

confidence: 99%

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

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“…When choosing this approach, NPPV is known to have a positive impact on sleep quality, dyspnoea, somnolence, exercise capacity and even pulmonary haemodynamics. 4,7,12,13,[21][22][23][24][25] Our data suggest that, despite initial positive effects of NPPV, specific HRQL assessed by SRI questionnaire obviously decreases in the long-term course of the disease. This is in contrast to the results of Masa and coworkers 4 who found that HRQL, using the SF-36, remained basically unchanged in the long run, that is, 1, 2 and 3 years after initiation of CPAP or NPPV.…”

Section: Functional Outcomementioning

confidence: 56%

“…[7][8][9] However, robust data on PH in OHS, particularly its prevalence in patients with NPPV, are scarce. [9][10][11][12][13] In a previous work, we determined PH by right heart catheterization (RHC) in a prospective cross-sectional study of clinically stable OHS patients, treated with NPPV for at least 3 months. 14 This study revealed that mild to moderate, predominately pre-capillary PH is common in OHS.…”

Section: Introductionmentioning

confidence: 99%

“…14 It has been hypothesised that PH in OHS is predominately linked to pulmonary vascular response to hypercapnia and hypoxia, 15 although pulmonary artery pressure obviously cannot be normalised in all patients despite NPPV therapy. [8][9][10]13,14 Surprisingly, PH has not yet been systematically explored in a larger cohort of patients with OHS with regard to long-term outcome, although Masa and coworkers recently showed that in patients with OHS and concomitant severe OSA, NPPV led to a reduction of systolic pulmonary artery pressure and left ventricle diastolic dysfunction. 13 Based on these considerations and the known impact of PH in other respiratory and/or pulmonary diseases, 16 we hypothesised that PH is a major prognostic factor in OHS and related to subjective outcome measures.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10]13,14 Surprisingly, PH has not yet been systematically explored in a larger cohort of patients with OHS with regard to long-term outcome, although Masa and coworkers recently showed that in patients with OHS and concomitant severe OSA, NPPV led to a reduction of systolic pulmonary artery pressure and left ventricle diastolic dysfunction. 13 Based on these considerations and the known impact of PH in other respiratory and/or pulmonary diseases, 16 we hypothesised that PH is a major prognostic factor in OHS and related to subjective outcome measures. Therefore, we re-evaluated OHS patients with established NPPV with regard to vital and functional status 5 years after a comprehensive cardiopulmonary assessment.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term outcome with focus on pulmonary hypertension in Obesity Hypoventilation Syndrome

Budweiser

Tratz

Gfüllner

et al. 2020

Clinical Respiratory J

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Introduction: Pulmonary Hypertension (PH) is a frequent comorbidity in Obesity Hypoventilation Syndrome (OHS). Objective: We investigated long-term outcome of OHS with a particular emphasis on PH. Methods: In a prospective design, 64 patients with OHS and established noninvasive positive pressure ventilation (NPPV), were assessed by serum biomarkers, right heart catheterization, blood gases analysis, lung function, Epworth-Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), World Health Organizationfunctional class (WHO-FC) and health-related quality of life (HRQL) via the Severe Respiratory Insufficiency (SRI) questionnaire. After a planned follow-up of 5 years patients were reassessed regarding vital status, WHO-FC, ESS, SRI, PSQI, body mass index (BMI) and NPPV use. Prognostic markers were explored using univariate and multivariate Cox regression analyses. Results: At the 5-year follow-up, BMI tended to decrease (P = 0.05), while WHO-FC, ESS and PSQI remained unchanged. HRQL deteriorated in terms of SRI summary score and most subdomains (P < .05 each). NPPV adherence still was high (89%), while daily NPPV use increased from 6.7 (5.1; 8.0) h/d to 8.2 (7.4; 9.0) h/d (P < .05). After a 5-year follow-up, mortality was 25.8%. In univariate regression analyses only age > 69.5 years (HR = 4.145, 95%-CI = 1.180-14.565, P = 0.016), NT-proBNP > 1256 pg/mL (HR = 5.162, 95%-CI = 1.136-23.467, P = 0.018), diffusion capacity for carbon monoxide (DLCO, %pred) (HR = 0.341, 95%-CI = 0.114-1.019, P = 0.043) and higher oxygen use during daytime (HR = 5.236, 95%-CI = 1.489-18.406, P = 0.004) predicted mortality. No independent factor predicting mortality was detected in multivariate analysis. Conclusion: Despite a high long-term NPPV use HRQL worsened. Age, oxygen use at baseline, DLCO (%pred) and NT-proBNP, as a surrogate parameter for PH, were related to long-term survival.

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Sleep and Hypoventilation

Piper

2022

Respiratory Medicine

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Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial

Cited by 39 publications

References 55 publications

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Long‐term outcome with focus on pulmonary hypertension in Obesity Hypoventilation Syndrome

Sleep and Hypoventilation

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