RT Journal Article
SR Electronic
T1 Pulmonary hypertension in obesity-hypoventilation-syndrome
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2376
VO 38
IS Suppl 55
A1 Christoph Kauppert
A1 Iris Dvorak
A1 Johannes Gebauer
A1 Florian Kollert
A1 Frank Heinemann
A1 Michael Pfeifer
A1 Stephan Budweiser
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2376.abstract
AB Introduction: In Obesity-Hypoventilation-Syndrome (OHS), pulmonary hypertension (PH) is considered a common feature.Aims: To determine frequency and severity of PH in OHS patients treated with non-invasive pressure ventilation (NPPV).Methods: Prospective cross-sectional study of consecutive patients admitted for follow-up of NPPV (initiated ≥3 months before). OHS was defined by BMI≥30kg/m2, capillary carbondioxid tension (PaCO2)≥45mmHg prior NPPV initiation without other causes for hypoventilation. Right-heart catheterization (RHC) was performed at rest without oxygen supplementation, daytime sleepiness measured by Epworth Sleepiness Scale (ESS).Results: 177 patients considered to have OHS were screened. Among 64 patients who met the diagnosis criteria for OHS, 21 patients (10f, 11m; median age 62.2 [53.9;71.7] years, BMI 45 [40;53] kg/m2, PaCO2 39.6 [37.8;45.5] mmHg) gave consent for RHC. Only 4 (19%) patients had normal mean pulmonary artery pressure (mPAP<20mmHg), mPAP 18 [15;18.5] mmHg and pulmonary vascular resistance index (PVRI) 224 [148;305] dyn*sec*m2/cm5; 8 patients (38.1%) presented with “Borderline”-PH (mPAP 20-24mmHg), mPAP 22 [22.5;23] mmHg and PVRI 392 [287;485] and 9 patients (42.9%) had a manifest PH (mPAP≥25mmHg), mPAP 33 [29;34] mmHg and PVRI 440 [384;728]. In 3 patients with PH, pulmonary capillary wedge pressure was >15mmHg; 2 of them presented with transpulmonary pressure gradient >12mmHg. In patients with PH, ESS (7 [6;11]) was significantly higher than in those without PH (3 [0.5;5.5], p=0.03) or Borderline-PH (3.5 [2.5;6.5], p=0.03).Conclusion: Mild to moderate PH is quite frequent in OHS, even after initiation of NPPV. Its impact on survival and quality of life has to be studied in future trials.