High Occurrence of Hypoxemic Sleep Respiratory Disorders in Precapillary Pulmonary Hypertension and Mechanisms

Jilwan, Fadia; Escourrou, P.; Garcia, Gilles; Jaïs, Xavier; Humbert, Marc; Roisman, Gabriel

doi:10.1378/chest.11-3124

Cited by 89 publications

(77 citation statements)

References 32 publications

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“…The prevalence of nocturnal hypoxaemia and central sleep apnoeas are high in PAH (70-80%) [41,42]. Overnight oximetry or polysomnography should be performed where obstructive sleep apnoea syndrome or hypoventilation are considered.…”

Section: Pulmonary Function Tests and Arterial Blood Gasesmentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

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Section: Pulmonary Function Tests and Arterial Blood Gasesmentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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“…They had symptoms of WHO functional class II or more (II/III/IV, 12/11/1 (50/46/4%), respectively). Median duration from symptom onset to first BPA was 13 [6,31] …”

Section: Patients Characteristicsmentioning

confidence: 99%

Effects of Balloon Pulmonary Angioplasty on Oxygenation in Patients With Chronic Thromboembolic Pulmonary Hypertension　– Importance of Intrapulmonary Shunt –

Aoki

Sugimura

Nochioka

et al. 2016

Circ J

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Background: Although balloon pulmonary angioplasty (BPA) improves the hemodynamics and prognosis of patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), the mechanisms of improvement in oxygenation remain to be elucidated. Methods and Conclusions:These results indicated that BPA improved not only pulmonary hemodynamics but also oxygenation with a resultant decrease in intrapulmonary shunt. (Circ J 2016; 80: 2227 -2234

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“…This could have been due to obstructive sleep apnea or nocturnal hypoxia from hypoventilation, both of which have been associated with pulmonary hypertension. [36][37][38] We do not have data on right heart catheterization on our patients.…”

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confidence: 99%

Sleep Disordered Breathing in Isolated Unilateral and Bilateral Diaphragmatic Dysfunction

Khan

Morgenthaler

Ramar

2014

Journal of Clinical Sleep Medicine

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Introduction:The effect of isolated unilateral or bilateral diaphragmatic dysfunction (DD), in the absence of a generalized neuromuscular disorder, on sleep disordered breathing (SDB) is not well understood. The type of positive airway pressure (PAP) device needed to treat SDB in patients with isolated DD is also not well established. Methods: We retrospectively analyzed data on patients with isolated unilateral or bilateral DD who were referred for polysomnography (PSG) for clinical symptoms or abnormal oximetry between 1994 and 2006. Results: We found 66 patients who met criteria, of whom 74.2% were males with an average age of 58.8 ± 10.9 years. 56 had isolated unilateral DD, and 10 had isolated bilateral DD. All had signifi cant SDB with an apnea-hypopnea index (AHI) of 26.6 ± 28.4. There were no signifi cant differences in PSG measures, arterial blood gas analysis, pulmonary function tests, or echocardiographic data, except for lower maximal inspiratory pressure in patients with bilateral DD compared to unilateral DD (40.2% ± 17.8% vs. 57.7% ± 20.5%, p = 0.02). Control of SDB with continuous PAP (CPAP) was possible in only 37.9% of patients with the rest requiring bilevel PAP (BPAP). Patients with isolated bilateral DD and SDB were 6.8 times more likely to fail CPAP than those with unilateral DD (p = 0.03). Conclusions: Most patients with isolated DD failed CPAP and required BPAP. Patients with bilateral DD were more likely to require BPAP than those with unilateral DD. Patients with isolated DD should be considered for in-lab titration to determine adequacy of therapy. Keywords: diaphragmatic weakness, diaphragmatic paralysis, sleep disordered breathing, obstructive sleep apnea, isolated diaphragmatic dysfunction, diaphragmatic dysfunction Citation: Khan A, Morgenthaler TI, Ramar K. Sleep disordered breathing in isolated unilateral and bilateral diaphragmatic dysfunction.

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High Occurrence of Hypoxemic Sleep Respiratory Disorders in Precapillary Pulmonary Hypertension and Mechanisms

Cited by 89 publications

References 32 publications

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Effects of Balloon Pulmonary Angioplasty on Oxygenation in Patients With Chronic Thromboembolic Pulmonary Hypertension　– Importance of Intrapulmonary Shunt –

Sleep Disordered Breathing in Isolated Unilateral and Bilateral Diaphragmatic Dysfunction

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High Occurrence of Hypoxemic Sleep Respiratory Disorders in Precapillary Pulmonary Hypertension and Mechanisms

Cited by 89 publications

References 32 publications

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Effects of Balloon Pulmonary Angioplasty on Oxygenation in Patients With Chronic Thromboembolic Pulmonary Hypertension – Importance of Intrapulmonary Shunt –

Sleep Disordered Breathing in Isolated Unilateral and Bilateral Diaphragmatic Dysfunction

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Effects of Balloon Pulmonary Angioplasty on Oxygenation in Patients With Chronic Thromboembolic Pulmonary Hypertension　– Importance of Intrapulmonary Shunt –