scholarly journals Association between sleep apnoea and pulmonary hypertension in Kyrgyz highlanders

2016 ◽  
Vol 49 (2) ◽  
pp. 1601530 ◽  
Author(s):  
Tsogyal D. Latshang ◽  
Michael Furian ◽  
Sayaka S. Aeschbacher ◽  
Silvia Ulrich ◽  
Batyr Osmonov ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pulmonary Hypertension ◽  
High Altitude ◽  
Body Mass ◽  
Sleep Apnoea ◽  
Night Time ◽  
Pulmonary Haemodynamics ◽  
Multivariable Regression ◽  
Independent Association ◽  
Control Study

This case–control study evaluates a possible association between high altitude pulmonary hypertension (HAPH) and sleep apnoea in people living at high altitude.Ninety highlanders living at altitudes >2500 m without excessive erythrocytosis and with normal spirometry were studied at 3250 m (Aksay, Kyrgyzstan); 34 healthy lowlanders living below 800 m were studied at 760 m (Bishkek, Kyrgyzstan). Echocardiography, polysomnography and other outcomes were assessed. Thirty-six highlanders with elevated mean pulmonary artery pressure (mPAP) >30 mmHg (31–42 mmHg by echocardiography) were designated as HAPH+. Their data were compared to that of 54 healthy highlanders (HH, mPAP 13–28 mmHg) and 34 healthy lowlanders (LL, mPAP 8–24 mmHg).The HAPH+ group (median age 52 years (interquartile range 47–59) had a higher apnoea–hypopnoea index (AHI) of 33.8 events·h−1(26.9–54.6) and spent a greater percentage of the night-time with an oxygen saturation <90% (T<90; 78% (61–89)) than the HH group (median age 39 years (32–48), AHI 9.0 events·h−1(3.6–16), T<90 33% (10–69)) and the LL group (median age 40 years (30–47), AHI 4.3 events·h−1(1.4–12.6), T<90 0% (0–0)); p<0.007 for AHI and T<90, respectively, in HAPH+versusothers. In highlanders, multivariable regression analysis confirmed an independent association between mPAP and both AHI and T<90, when controlled for age, gender and body mass index.Pulmonary hypertension in highlanders is associated with sleep apnoea and hypoxaemia even when adjusted for age, gender and body mass index, suggesting pathophysiologic interactions between pulmonary haemodynamics and sleep apnoea.

scholarly journals BASAN index (Body mass index, Age, Sex, Arterial hypertension and Neck circumference) predicts severe apnoea in adults living at high altitude

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044228
Author(s):  
Henry Oliveros ◽  
Rafael Lobelo ◽  
Luis Fernando Giraldo-Cadavid ◽  
Alirio Bastidas ◽  
Constanza Ballesteros ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Arterial Hypertension ◽  
High Altitude ◽  
Body Mass ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Derivation Cohort ◽  
Obstructive Sleep

ObjectivesObstructive sleep apnoea (OSA)/hypopnoea syndrome is associated with serious and major multiorgan morbidities, particularly in its most severe forms. However, no severe OSA screening instruments are available for high altitude residents that enable adequate identification and clinical prioritisation of such patients. We aimed at developing a severe OSA prediction tool based on the clinical characteristics and anthropometric measurements of a clinical referral cohort living at 2640 m.a.s.l.DesignCohort-nested cross-sectional study.SettingSleep laboratory for standard polysomnography (PSG) in Colombia.ParticipantsA predictive model was generated from 8718 participants referred to the PSG laboratory. Results were subsequently validated in a second cohort of 1898 participants.Primary outcomeTo identify clinical and anthropometric variables associated with severe OSA (>30 events/hour) and to include them in a binary logistic regression model.ResultsThe significant variables that were retained with the presence of severe OSA included Body mass index (BMI), Age, Sex, Arterial hypertension and Neck circumference (BASAN). The area under the receiver operating characteristic curvefor the BASAN index was 0.69 (95% CI: 0.68 to 0.70) in the derivation cohort and 0.67 (95% CI: 0.65 to 0.69) in the validation cohort, whereby a BASAN index ≥2 had a sensitivity of 95% and a specificity of 17% to detect severe OSA.ConclusionAn objectively based approach to screen for the presence of severe OSA, the BASAN index, exhibits favourable sensitivity characteristics that should enable its operational use as a screening tool in a Hispanic population with a clinical suspicion of OSA and living at high altitude.

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

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.

scholarly journals Sleep apnoea and incident malignancy in type 2 diabetes

2021 ◽  
pp. 00036-2021
Author(s):  
Sarah Driendl ◽  
Michael Arzt ◽  
Claudia S. Zimmermann ◽  
Bettina Jung ◽  
Tobias Pukrop ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Cox Regression ◽  
Smoking Status ◽  
Ambulatory Monitoring ◽  
Sleep Apnoea ◽  
Night Time ◽  
Peripheral Oxygen Saturation

BackgroundSleep apnoea (SA) and type 2 diabetes (T2D) have been linked to malignancy. The aim of the present study was to evaluate the association between SA and incidence of malignancy in patients with T2D.MethodsThe DIACORE (DIAbetes COhoRtE) study is a prospective, population-based cohort study in T2D patients. In the SDB (sleep-disordered breathing) sub-study, the apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI) and percentage of night-time spent below a peripheral oxygen saturation of 90% (TSat90%) were assessed using a two-channel ambulatory monitoring device. Malignancy diagnoses were gathered using self-reported medical history data validated by medical records. Hazard ratios (HR) for incident malignancy were derived by Cox regression adjusting for sex, age, body-mass index, smoking status, alcohol intake, socioeconomic status and HbA1c.ResultsOf 1239 patients with T2D (mean age 67 years, 41% female, mean body-mass index 30.9 kg m−2), 79 (6.4%) were first-time diagnosed with a malignancy within a median follow-up period of 2.7 (interquartile range 2.2; 4.5) years. AHI, ODI and TSat90% were not associated with incident malignancy. In subgroup analysis, women showed increased cancer risk per AHI unit (adjusted HR 1.03 per AHI unit, 95% CI [1.00–1.06], p=0.028) and severe SA (defined as AHI≥30 h−1; adjusted HR 4.19, 95% CI [1.39–12.77], p=0.012). This was not seen in men, and a significant interaction was observed (interaction terms, p=0.048, p=0.033, respectively).ConclusionSA was not associated with incident malignancy in T2D patients. However, stratified analysis revealed a significant association between SA and incident malignancy in women, but not in men.

scholarly journals Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors

2018 ◽  
Vol 4 (1) ◽  
pp. 00079-2017 ◽  
Author(s):  
Todd M. Tartavoulle ◽  
Aryn C. Karpinski ◽  
Andrew Aubin ◽  
Benzi M. Kluger ◽  
Oliver Distler ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pulmonary Hypertension ◽  
Receptor Antagonist ◽  
Body Mass ◽  
Phosphodiesterase Inhibitor ◽  
Endothelin Receptor Antagonist ◽  
Endothelin Receptor ◽  
Physical Fatigue ◽  
General Fatigue ◽  
Reduced Activity

Pulmonary hypertension is a potentially fatal disease. Despite pharmacological advances in pulmonary hypertension, fatigue remains common in patients with pulmonary hypertension.A convenience sample of 120 participants at an international patient conference completed the Multidimensional Fatigue Inventory (MFI)-20 scale. Data on New York Heart Association Functional Class, body mass index, oxygen use and medication type/use were also collected.There was a high prevalence of “severe” to “very severe” fatigue for each dimension: General Fatigue (60%), Physical Fatigue (55.8%), Reduced Activity (41.7%), Reduced Motivation (32.5%) and Mental Fatigue (27.5%). The mean±sd overall MFI-20 score was 58±5.1. Dimensions with the highest averaged levels were General Fatigue (13.40±3.61), Physical Fatigue (13.23±3.67) and Reduced Activity (11.33±4.16). Body mass index correlated with higher fatigue scores. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination negatively predicted General Fatigue, Physical Fatigue, Reduced Motivation and Reduced Activity. Triple therapy was a significant predictor of General Fatigue, Physical Fatigue and Reduced Activity. There were no significant predictors of Mental Fatigue.Multidimensional fatigue is common and severe in patients with pulmonary hypertension. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination resulted in lower scores in most fatigue dimensions. Comprehensive assessment of fatigue should be considered in the clinical care of patients with pulmonary hypertension and clinical research to develop formal interventions that target this disabling symptom.

scholarly journals Body mass index, height and early-onset basal cell carcinoma in a case-control study

2016 ◽  
Vol 22 (9) ◽  
Author(s):  
Yanchang Zhang ◽  
Brenda Cartmel ◽  
Courtney C Choy ◽  
Annette M Molinaro ◽  
David J Leffell ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Body Mass ◽  
Basal Cell ◽  
Early Onset ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

scholarly journals Subclinical left ventricular disfunction in obese children: are we late?

2020 ◽  
Author(s):  
B Riaño-Mendez ◽  
M Ruiz del Campo ◽  
P Garcia-Navas ◽  
CM Amiama-Perez de Villarreal ◽  
MY Ruiz del Prado
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Mass ◽  
Systolic Function ◽  
Left Ventricular ◽  
Function Evaluation ◽  
Obese Children ◽  
Global Strain ◽  
Cardiovascular Evaluation ◽  
Control Study

ABSTRACTAimLongitudinal global strain (LGS) is reduced in obese patients with normal ejection fraction of the left ventricle. TAPSE/PAPS ratio, recently described, may be a step forward a more efficient RV function evaluation.There are still few publications in the application of these methods in pediatric patients.MethodsThis case-control study compared 104 children aged 5-18 years between October 2017 and February 2019, 52 obese children with body mass index (BMI) > +2 SD, and 52 matched controls.They were screened for other cardiovascular risk factors like insulin resistance or hypercholesterolemia. A complete echocardiography including standard and functional parameters was performed.ResultsWe found that obese children presented poor systolic function (LGS −15,90 ± 3,84 %) in comparison with non-obese children (−19,44 ± 5,75 %, p=0,001). LGS correlated positively with body mass index (BMI).Standard echocardiography also revealed cardiomegaly and hypertrophy.TAPSE/PASP ratio correlated negatively with triglycerides levels (β −0,402, p=0,014). Diastolic function was poor in those with HOMA-IR (β −0,375, p=0,016) and hypertriglyceridemia (β −0,375 p=0,024).ConclusionWe think that is necessary to perform a standarised cardiovascular evaluation in obese children for early identification of subclinical dysfunction especially in those with insulin resistance and dyslipidemia

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