Cardiohemodynamics parameters in patients with COPD and obstructive sleep apnea, (OSA)

OSA causes chronic hypoxia that adversely affects the clinical manifestations of COPD and may impair cardiac function.The aim is to study cardiohemodynamics in patients with COPD and OSA.A total of 46 pts, 32 men, 14 women, average age of 63,85 (8,34) years, with COPD gr. B and C were examined. Standard values of systolic and diastolic heart function, mean pressure in the pulmonary artery (PAPmean) and the right ventricle (RV) size were measured by EchoCG. OSA was diagnosed by Somnocheck-Micro method. The severity of OSA was assessed by apnea/hypopnea index (AHI).OSA was diagnosed in 67 (44.14%) pts, which were divided into 3 groups. Group I- 26 pts with mild OSA, AHI = 9,62 (2,74), gr.II - 17 pts with moderate OSA, AHI = 21,23 (4,41), gr III - 24 pts with severe OSA, AHI = 48.85 (11.91). Cardiac output (CO) decreased as the worsening of OSA: 4.88 (1.50) l/min in group I (p=0,041) vs 5,03 (1,99) l/min in gr.II (p=0,491) vs 3,49 (4,72) l/min in gr.III (p=0,002). PAPmean was 24,97 (14,82) mmHg in gr.I vs 29,47(11,80) mmHg in gr. II (p=0,043) vs 36,31 (12,03) mmHg in gr.III (p=0,016). RV diastolic dysfunction (DD) was evaluated in gr. I (E/A = 0,72 (0,21) vs 0,66 (0,17) in gr. II (p=0,043). Restrictive tricuspid flow E/A=1,46 (0,62) was in gr III (p <0,01). RV dilatation increased as the worsening of OSA: 2,83 (0,33) cm in gr.II vs 3,13 (1.54) cm in gr.III (p=0,046). LVEF and LV EDV were not statistically different from the normal values, a moderate LV DD was present in all g...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and Control of Breathing Source Type: research