Cardiopulmonary disorders in patients with obstructive sleep apnea syndrome. Pulmonary hypertension.:Pulmonary Hypertension

概要

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Recently, it was recognized that cardiac arrythmia or pulmonary hypertension (PH) was occurred during apnea in patients with sleep apnea syndrome (SAS), and those cardiopulmonary disorders might influence the prognosis of SAS. But the frequency and the mechanisms of PH have not been well known. Therefore, we carried out a polysomnographic sleep study, including continuous recordings of pulmonary artery pressure, systemic artery pressure and cardiac output in 11 patients with obstructive SAS.Only 2 of 11 patients (19%) showed pulmonary hypertension during daytime (PPA≥20Torr). Blood gas analysis of these patients showed hypoxemia and hypercapnemia: PaO2 48.1Torr, PaCO2 48.6Torr and PaO2 57.9Torr, PaCO2 50.9Torr, respectively. It was suggested that only the SAS patient with hypoxemia and hypercapnemia during wakefullness was a candidate for pulmonary hypertension during daytime. Precise analysis of hemodynamic recordings during apneic phase from a case of primary alveolar hypoventilation syndrome and a case of obstructive sleep apnea syndrome showed significant contribution of hypoxic pulmonary vasoconsriction to the development of severe pulmonary hypertension during apnea in these patients. And the effect of intrathoracic pressure oscillations with distinct intrathoracic suction during obstructive apnea on the pulmonary hemodynamic changes was discussed.
特定非営利活動法人日本気管食道科学会の論文