Kauppert, Christoph A. and Dvorak, Iris and Kollert, Florian and Heinemann, Frank and Joerres, Rudolf A. and Pfeifer, Michael and Budweiser, Stephan (2013) Pulmonary hypertension in obesity-hypoventilation syndrome. RESPIRATORY MEDICINE, 107 (12). pp. 2061-2070. ISSN 0954-6111, 1532-3064
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Background: Pulmonary hypertension (PH) is considered a clinically important feature of Obesity-Hypoventilation Syndrome (OHS). We aimed to determine prevalence, characteristics and severity of PH including associations with clinical outcomes after established non-invasive positive pressure ventilation (NPPV). Methods: In a prospective cross-sectional study, clinically stable OHS-patients (NPPV duration >= 3 months) were consecutively assessed using echocardiography, serum markers and right-heart catheterization (RHC). NPPV use was quantified via ventilator counters. Blood gases, lung function, Epworth-Sleepiness Scale (ESS), sleep-quality, WHO-functional class (WHO-FC), 6-min walk distance, and health-related quality of life (HRQL) via Severe Respiratory Insufficiency (SRI) questionnaire were assessed. Results: Of 177 patients considered, 64 fulfilled inclusion criteria. Among these, 21 patients (10 female/11 mate; BMI 45 [40; 53] kg/m(2), PaCO2 39.6 [37.8; 45.5] mmHg (median [quartiles])) gave consent for RHC. Four patients (19%) had normal mean pulmonary artery pressure (mPAP < 20 mmHg), 8 (38.1%) mPAP 20-24 mmHg and 9 (42.9%) manifest PH (mPAP >= 25 mmHg), 3 of them with combined pre- and/or postcapillary PH. mPAP was negatively correlated to NPPV use, vital capacity and lung diffusing capacity (p < 0.01 each), and positively to BMI (p < 0.05). NPPV use and vital capacity independently predicted mPAP. In patients with PH, ESS, WHO-FC, and some SRI-items were worse (p < 0.05 each) compared to patients without PH. Multivariate analyses revealed mPAP as the only independent predictor of the SRI-physical functioning domain. Conclusions: Mild to moderate PH is frequent in patients with OHS despite NPPV, mPAP being inversely related to NPPV adherence. PH is associated with impairments in daytime-sleepiness, WHO-FC, HRQL and physical functioning. (C) 2013 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITIVE-PRESSURE VENTILATION; NONINVASIVE MECHANICAL VENTILATION; 6-MINUTE WALK TEST; QUALITY-OF-LIFE; RESPIRATORY-FAILURE; ARTERIAL-PRESSURE; EUROPEAN-SOCIETY; LUNG-VOLUMES; IMPACT; GUIDELINES; Obesity hypoventilation; Pulmonary hypertension; Respiratory failure; Right heart failure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Apr 2020 05:35 |
| Last Modified: | 06 Apr 2020 05:35 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15559 |
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