Echocardiographic Findings in Obesity Hypoventilation Syndrome
Journal Title: Türk Uyku Tıbbı Dergisi - Year 2017, Vol 4, Issue 3
Abstract
Objective: In Obesity Hypoventilation syndrome (OHS), pulmonary hypertension (PH) is an important morbidity and mortality reason compared to pure Obstructive Sleep Apnea syndrome (OSAS). However, few studies are available in the literature about this subject. For this reason, we evaluated OHS and pure OSAS cases in our study from the point of right heart-related echocardiographic parameters and PH. Materials and Methods: Obese [body mass index (BMI) >30 kg/m2] cases diagnosed by polysomnography were included in the study. The subjects were divided to two groups as OHS and pure OSAS. OHS criteria were defined as obesity (BMI >30 kg/m2) and for another reason unexplained (neuromuscular, chest wall, restrictive or obstructive pulmonary diseases) daytime hypercapnia (PaCO2 >45 mmHg). Patients with severe hypothyroidism, renal and heart insufficiency, cardiac drug anamnesis were not included in the study. Transthoracic echocardiography was performed to all cases and those with left-heart pathology were excluded from the study. Systolic pulmonary artery pressure (PABs) >35 mmHg was accepted as PH. Results: Of the 115 cases studied (mean age: 49.3±10.6/year, female/male: 53/62, BMI: 40.5±6.1 kg/m2), 70 were pure OSAS and 45 were OHS. In the OHS group, PABs, right ventricular diameter and pulmonary velocities were significantly higher than the pure OSAS group (p=0.002, p=0.015, p=0.012, respectively). The frequency of PH in OHS was significantly higher than group with pure OSAS (48.8% vs. 17.1%, p<0.001). In the overall group, there was a positive correlation between PABs value and apnea-hypopnea index, OSAS phase, oxygen desaturation index, SpO2 <90% elapsed time, and OHS presence (r=0.307, p=0.001; r=0.259, p=0.005; r=0.405, p<0.001; r=0.162, p<0.001; r=0.305, p=0.001, respectively). There was negative correlation between PABs and mean and minimum SpO2 (r=-0.404, p<0.001; r=-0.344, p<0.001, respectively). Conclusion: In OHS cases; PAPs, right ventricular diameter and pulmonary velocities, and PH frequency are higher than pure OSAS. Echocardiographic evaluation should be routinely performed for OHS cases.
Authors and Affiliations
Aylin Pıhtılı, Ekrem Karaayvaz, Züleyha Bingöl, Ahmet Kaya Bilge, Gülfer Okumuş, Esen Kıyan
Keywords
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