Hypoxemia during sleep and overnight rostral fluid shift in pulmonary arterial hypertension: a pilot study
Autor: | David Montani, Olivier Sitbon, Thomas Similowski, Marc Humbert, Sven Günther, Gilles Garcia, Caroline Sattler, Isabelle Arnulf, Stefania Redolfi, Etienne-Marie Jutant |
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Přispěvatelé: | Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre Chirurgical Marie Lannelongue (CCML), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Innovations thérapeutiques en hémostase (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pathologies du sommeil [CHU Pitié-Salpêtrière], Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, Centre chirurgical Marie Lannelongue, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Pathologies du sommeil [CHU Pitié-Salpêtrière], Neurophysiologie Respiratoire Expérimentale et Clinique |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Central sleep apnea Heart disease [SDV]Life Sciences [q-bio] sleep-related breathing disorders sleep hypoxemia Polysomnography 030204 cardiovascular system & hematology rostral fluid shift Hypoxemia 03 medical and health sciences 0302 clinical medicine Internal medicine pulmonary hypertension medicine Original Research Article lcsh:RC705-779 medicine.diagnostic_test business.industry Apnea Sleep apnea lcsh:Diseases of the respiratory system medicine.disease sleep apnea Pulmonary hypertension 3. Good health [SDV] Life Sciences [q-bio] medicine.anatomical_structure lcsh:RC666-701 Cardiology Vascular resistance medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Pulmonary Circulation Pulmonary Circulation, 2021, 11 (2), pp.204589402199693. ⟨10.1177/2045894021996930⟩ Pulmonary Circulation, Vol 11 (2021) |
ISSN: | 2045-8940 |
Popis: | International audience; Sleep-related breathing disorders, including sleep apnea and hypoxemia during sleep, are common in pulmonary arterial hypertension, but the underlying mechanisms remain unknown. Overnight fluid shift from the legs to the upper airway and to the lungs promotes obstructive and central sleep apnea, respectively, in fluid-retaining states. The main objective was to evaluate if overnight rostral fluid shift from the legs to the upper part of the body is associated with sleep-related breathing disorders in pulmonary arterial hypertension. In a prospective study, a group of stable patients with idiopathic, heritable, related to drugs, toxins, or treated congenital heart disease pulmonary arterial hypertension underwent a polysomnography and overnight fluid shift measurement by bioelectrical impedance in the month preceding or following a one-day hospitalization according to regular pulmonary arterial hypertension follow-up schedule with a right heart catheterization. Results show that among 15 patients with pulmonary arterial hypertension (women: 87%; median (25-75th percentiles); age: 40 (32-61) years; mean pulmonary arterial pressure 56 (46-68) mmHg; pulmonary vascular resistance 8.8 (6.4-10.1) Wood units), two patients had sleep apnea and eight (53%) had hypoxemia during sleep without apnea. The overnight rostral fluid shift was 168 (118-263) mL per leg. Patients with hypoxemia during sleep had a greater fluid shift (221 (141- 361) mL) than those without hypoxemia (118 (44-178) mL, p = 0.045). In conclusion, this pilot study suggests that hypoxemia during sleep is associated with overnight rostral fluid shift in pulmonary arterial hypertension. |
Databáze: | OpenAIRE |
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