The clinical characteristics of patients with pulmonary hypertension combined with obstructive sleep apnoea

Abstract Objective Obstructive sleep apnoea (OSA) is one cause of pulmonary hypertension (PH) and can also emerge along with PH. The clinical diagnosis and treatment of OSA in patients with PH are still controversial. The purpose of this clinical observation study was to observe and summarize the incidence and clinical characteristics of OSA in patients with PH and to explore possible predictors of PH combined with OSA. Methods Patients with PH diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from December 2018 to December 2020 were enrolled. OSA was defined as an apnoea–hypopnoea index of ≥ 5/h with ≥ 50% of apnoeic events being obstructive. Baseline clinical characteristics and parameters were collected to compare PH patients with and without OSA. Logistic regression analysis was run to determine the risk factors for OSA in PH patients. Results A total of 35 (25%) of 140 patients had OSA. OSA is relatively frequent in patients with PH, especially in patients with chronic thromboembolic pulmonary hypertension and patients with lung disease– or hypoxia-associated PH. The patients who had OSA were mostly male and had a higher age and a lower daytime arterial oxygen pressure. Logistic regression analysis found that older age, male sex, and lower daytime arterial blood oxygen pressure correlated with OSA in PH patients. Conclusion OSA is common in patients with PH. Lower daytime arterial oxygen pressure is a risk factor for OSA in older male patients with PH.

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Pulmonary hypertension in the obstructive sleep apnoea syndrome: prevalence, causes and therapeutic consequences

CrossRef Listing of Deleted DOIs ◽

10.1183/09031936.96.09040787 ◽

1996 ◽

Vol 9 (4) ◽

pp. 787-794 ◽

Cited By ~ 117

Author(s):

R. Kessler ◽

A. Chaouat ◽

E. Weitzenblum ◽

M. Oswald ◽

M. Ehrhart ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Obstructive Sleep Apnoea Syndrome ◽

Sleep Apnoea Syndrome ◽

Therapeutic Consequences ◽

Obstructive Sleep

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Sex-Disaggregated Data on Clinical Characteristics and Outcomes of Hospitalized Patients With COVID-19: A Retrospective Study

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.680422 ◽

2021 ◽

Vol 11 ◽

Author(s):

Mengdie Wang ◽

Nan Jiang ◽

Changjun Li ◽

Jing Wang ◽

Heping Yang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Clinical Characteristics ◽

Random Effect ◽

Hospitalized Patients ◽

Male And Female ◽

Female Patients ◽

Disease Outcomes ◽

Male Patients

BackgroundSex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19.MethodIn this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes.ResultsA total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age.ConclusionsMale patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.

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Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants

Pulmonary Circulation ◽

10.1177/2045894018760166 ◽

2018 ◽

Vol 8 (2) ◽

pp. 204589401876016 ◽

Cited By ~ 2

Author(s):

Sook Kyung Yum ◽

Min-Sung Kim ◽

Yoojin Kwun ◽

Cheong-Jun Moon ◽

Young-Ah Youn ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Logistic Regression ◽

Regression Analysis ◽

Preterm Infants ◽

Logistic Regression Analysis ◽

Multivariable Logistic Regression Analysis ◽

Multivariable Logistic Regression ◽

Histologic Chorioamnionitis ◽

Respiratory Outcomes ◽

Lower Birthweight

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC. Potential risk factors associated with the development of PH during NICU stay were used for multivariable logistic regression analysis. A total of 188 infants were enrolled: 72 in the HC group and 116 in the no HC group. The HC group infants were born at a significantly shorter gestational age and lower birthweight, with a greater proportion presenting preterm premature rupture of membrane (pPROM) > 18 h before delivery. More infants in the HC group developed pneumothorax ( P = 0.008), and moderate and severe bronchopulmonary dysplasia (BPD; P = 0.001 and P = 0.006, respectively). PH in the HC group was significantly more frequent compared to the no HC group (25.0% versus 8.6%, P = 0.002). Based on a multivariable logistic regression analysis, birthweight ( P = 0.009, odds ratio [OR] = 0.997, 95% confidence interval [CI] = 0.995–0.999), the presence of HC ( P = 0.047, OR = 2.799, 95% CI = 1.014–7.731), and duration of invasive mechanical ventilation (MV) > 14 days ( P = 0.015, OR = 8.036, 95% CI = 1.051–43.030) were significant factors. The presence of HC and prolonged invasive MV in infants with lower birthweight possibly synergistically act against preterm pulmonary outcomes and leads to the development of PH. Verification of this result and further investigation to establish effective strategies to prevent or ameliorate these adverse outcomes are needed.

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Clinical Characteristics and Outcomes of Patients with Obstructive Sleep Apnoea Requiring Intensive Care

Anaesthesia and Intensive Care ◽

10.1177/0310057x1003800315 ◽

2010 ◽

Vol 38 (3) ◽

pp. 506-512 ◽

Cited By ~ 7

Author(s):

L. W. Hang ◽

W. Chen ◽

S. J. Liang ◽

Y. C. Lin ◽

C. Y. Tu ◽

...

Keyword(s):

Intensive Care ◽

Obstructive Sleep Apnoea ◽

Clinical Characteristics ◽

Sleep Apnoea ◽

Obstructive Sleep

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Psychosis in Sleep Apnoea

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048678909062627 ◽

1989 ◽

Vol 23 (4) ◽

pp. 571-573 ◽

Cited By ~ 14

Author(s):

Sing Lee ◽

Helen F.K. Chiu ◽

Char-Nie Chen

Keyword(s):

Sleep Deprivation ◽

Obstructive Sleep Apnoea ◽

Complete Resolution ◽

Slow Wave Sleep ◽

Sleep Apnoea ◽

Arterial Oxygen ◽

Obstructive Sleep Apnoea Syndrome ◽

Intellectual Impairment ◽

Obstructive Sleep

A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.

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The prevalence and clinical characteristics of diabetes mellitus in Chinese inpatients with chronic schizophrenia: a multicenter cross-sectional study

PeerJ ◽

10.7717/peerj.12553 ◽

2021 ◽

Vol 9 ◽

pp. e12553

Author(s):

Yanni Wang ◽

Lingyun Zeng ◽

Lijuan Chen ◽

Xin Zhou ◽

Lijuan Huo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Clinical Characteristics ◽

Chronic Schizophrenia ◽

Cross Sectional Study ◽

World Health ◽

Sectional Study ◽

Cross Sectional

Background Diabetes mellitus (DM) is common among patients with schizophrenia. However, information on patients comorbid DM and schizophrenia is limited in China. The present study investigated the prevalence of DM and its clinical characteristics in Chinese inpatients with chronic schizophrenia. Methods A cross-sectional study was performed in Chinese inpatients with chronic schizophrenia. Diagnosis of Diabetes was established using World Health Organization diagnostic criteria for diabetes mellitus (persistent fasting glucose levels ≥ 126 mg/dl or 2-h plasma glucose ≥ 200 mg/dL after a 75-g Oral Glucose Tolerance Test). Patients were also measured height, weight, waist circumference, hip circumference, triglyceride level, and cholesterol level. Patients’ psychiatric symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression analysis was performed to examine the associated demographic and clinical variables in chronic schizophrenia. Results A total of 988 inpatients (64.6% male, average age of 47.19 ± 12.55) was recruited. The prevalence of DM in Chinese patients with chronic schizophrenia was 13.8% (95% CI [11.6–15.9]%). Logistic regression analysis showed that overweight (OR = 1.90, 95% CI [1.20–3.03], p = 0.006), obesity (OR = 1.85, 95% CI [1.07–3.21], p = 0.028), comorbid hypertension (OR = 2.14, 95% CI [1.34–3.42], p = 0.002), and course of schizophrenia (OR = 1.03, 95% CI [1.01–1.06], p = 0.040) were significantly associated with the DM risk in patients with schizophrenia. Conclusion The findings indicated that diabetes mellitus was non-negligible in patients with chronic schizophrenia. Patients with schizophrenia should be regularly monitored for DM. Overweight/obesity, long duration of schizophrenia, and comorbid hypertension possibly were risk factors for diabetes.

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Correlation of body mass index and pulmonary hypertension in patients with obstructive sleep apnoea

The Journal of Community Health Management ◽

10.18231/j.jchm.2021.018 ◽

2021 ◽

Vol 8 (2) ◽

pp. 79-82

Author(s):

Saurabh Mishra ◽

G N Srivastava ◽

J K Mishra ◽

Ritamvara Oli

Keyword(s):

Body Mass Index ◽

Pulmonary Hypertension ◽

Body Mass ◽

Obstructive Sleep Apnoea ◽

Severe Obesity ◽

Strong Association ◽

Sleep Apnoea ◽

Cardiac Anomaly ◽

2D Echocardiography ◽

Obstructive Sleep

Obstructive sleep apnoea has very strong association with both body mass index and pulmonary hypertension. There is a paucity of data to relate BMI and PH in patients with OSA. To see the relation between body mass index and pulmonary hypertension in patients with obstructive sleep apnoea. Patients with symptoms of OSA were screened for polysomnography by using STOP-BANG criteria. 100 patients with AHI ≥5 with symptoms of obstructive sleep apnoea and AHI ≥ 15 without symptoms of obstructive sleep apnoea were selected for other investigations. Neck circumference was measured and BMI was calculated to estimate the severity of obstruction. PFT and chest X-ray were done to rule-out other respiratory illnesses. 2D-echocardiography was done for screening of pre-existing structural cardiac anomaly or any raise in pulmonary artery pressure. MRI neck was done to check neck muscles status. Out of 100 patients in study group 10% (n=10) had mild, 12% (n=12) had moderate and 78% (n=78) had severe OSA. Most of the patients belonged to overweight (52%) and obesity stage 1 (34%) groups. 10% and 2% of the patients belonged to obesity stage 2 and severe obesity groups respectively. Only 2% of the patients were healthy and none of the patients were underweight. PH was present in 24% (n=24) of cases, mild (n=10) and moderate (n=10) PH each were 10% and severe (n=4) PH was present in 4% of the cases. 100% of the patients with severe obesity had pulmonary hypertension. Most of the patients with PH belonged to Obesity grade 1 and overweight groups, whereas none of normal BMI patients had PH. Body mass index has indirect relation with pulmonary hypertension. In our study, we found that pulmonary hypertension was present only in overweight and obese patients. Whereas, none of the patients with normal BMI had pulmonary hypertension.

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Association of PIK3CA mutations and age with the occurence of second primary lung cancer (SPLC).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1589 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1589-1589

Author(s):

Marc Christiaan Allardt Bos ◽

Masyar Gardizi ◽

Matthias Scheffler ◽

Lucia Nogova ◽

Thomas Zander ◽

...

Keyword(s):

Lung Cancer ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Clinical Characteristics ◽

Pik3ca Mutation ◽

Primary Lung Cancer ◽

Driver Mutations ◽

Second Primary ◽

Pik3ca Mutations

1589 Background: The incidence of SPLC in Germany was reported to be 1.2 per 100,000 inhabitants in 2007 and the prevalence of second primary cancers reported by the US International Cancer Institute's Surveillance, Epidemiology and End Results Program has more than doubled over the last 25 years. Recently there has been tremendous progress in the ability to detect driver mutations in lung cancer and large studies presented the frequencies of driver mutations in unselected patient populations. We conducted an association study of known genetic driver events and clinical characteristics with the occurence of SPLC. Methods: Within the Network Genomic Medicine Lung Cancer, a local molecular screening network encompassing hospitals and office-based oncologists in the catchment area of the Center for Integrated Oncology Köln Bonn, we retrospectively reviewed the medical records of 375 molecularly annotated NSCLC patients for their SPLC status and clinical characteristics (age at diagnosis, histology, sex, smoking status). Molecular analysis for lung adenocarcinoma included the EGFR, ALK, BRAF, KRAS and PIK3CA status and for squamous cell lung cancer the FGFR1 and PIK3CA status. Results: 84 of 375 (22,4%) patients were SPLCs. The median age of SPLC diagnosis was 70 yrs. (Range 53 - 85 yrs.) and differed significantly from the rest of the population with a median age of 65 yrs. (Range 28 - 86 yrs.). The frequency of SPLCs was not significantly different between males and females (p = 0,259). In univariate logistic regression analysis active and former smoking, positive PIK3CA mutation and FGFR1 amplification status as well as age were significantly associated with the occurrence of SPLC. In a multivariate logistic regression analysis including the variables mentioned above only PIK3CA mutations (OR 9,48 95% CI 1,83 - 49,1) (p = 0,007) and age (OR 1,06 95% CI 1,03 - 1,1) (p = 0,015) could be confirmed to be independent prognosticators for the occurrence of SPLCs. Conclusions: The occurrence of SPLC was associated with age and PIK3CA mutations in our study population. Further comprehensive investigations on this topic are needed to confirm our findings and to further understand the association between mutation status and SPLCs.

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