Factors associated with the prevalence of pulmonary hypertension in patients with sleep overlap syndrome

doi:10.3969/j.issn.1006-7795.2020.03.029

Abstract

Abstract: Objective To elucidate the independent correlative factors for polysomnography and spirometry related to pulmonary hypertension (PH) among patients with sleep overlap syndrome (OS). Methods Totally 128 subjects were recruited in the Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University from January 2019 to January 2020. Spirometry and full-night sleep test were carried out to identify chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA). OSA was identified if an apnea-hypopnea index(AHI) was higher than 5 events/hour. OS was diagnosed when patients met both criteria of COPD and OSA. Independent correlative factors for the prevalence of PH were surveyed by multiple stepwise Logistic regression with age, sex and body mass index adjusted for. Results Compared with subjects with isolated OSA and COPD, the patients with OS had lower nadir nocturnal saturation (82% and 90% vs 79%, P<0.001) and average nocturnal saturation (93% and 95% vs 92%, P<0.001), but higher percentage of total sleep time with saturation <90% (6% and 0% vs 11%, P<0.001). The PH prevalence in the patients with forced expiratory volume <80% predicted value in the first second (FEV₁) was 2.78 times higher than that in the patients with FEV₁ ≥ 80% predicted value (OR 2.78, 95%CI 1.05-7.38, P=0.040). The PH prevalence was higher in the patients with AHI ≥ 15 events/h than those with AHI <15 events/h (OR 3.46, 95%CI 1.02-11.71, P=0.046). After adjusting for confounding variables, the PH prevalence was 3.57 higher in the patients with FEV₁<80% predicted value than those with FEV₁ ≥ 80% predicted value (OR 3.57, 95%CI 1.20-10.62, P=0.022). Conclusion Pulmonary ventilatory defect is independently associated with the prevalence of PH. Further studies are needed to investigate whether effective interventions may alleviate PH prevalence and thus improve long term prognosis in the patients with OS.

Key words: sleep overlap syndrome, pulmonary hypertension, chronic obstructive pulmonary disease, obstructive sleep apnea

CLC Number:

Fan Zhengyang, Xie Jiang, Li Fei, Wang Jingting, Patiguli·Yisilamu, Sun Dance. Factors associated with the prevalence of pulmonary hypertension in patients with sleep overlap syndrome[J]. Journal of Capital Medical University, 2020, 41(3): 482-487.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2020.03.029

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2020/V41/I3/482

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