阻塞性睡眠呼吸暂停和肺高血压之间的关系:过去,现在和未来
Jyotirmayee Lenka1, Raymond Foley1, Mark Metersky1
1Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut, Farmington, CT, USA.
Expert review of respiratory medicine
|April 22, 2024
概括
阻塞性睡眠呼吸暂停 (OSA) 可能导致肺高血压 (PH). 新的睡眠研究指标,而不仅仅是AHI,对于PH患者的风险评估至关重要,以指导像PAP疗法这样的治疗.
科学领域:
- 肺部医学 肺部医学
- 睡眠医学 睡眠医学
- 心脏病学 心脏病学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是常见的,并与心血管问题有关.
- 虽然OSA影响肺血液动力学,但其在发展临床肺高血压 (PH) 中的作用仍然不确定.
研究的目的:
- 审查OSA和PH之间的关联.
- 探索OSA的病理生理学,新型指标和内分类型.
- 为潜在的OSA的PH患者推风险评估和查策略.
主要方法:
- 关于OSA和PH的研究的文献综述.
- 对病理生理机制的分析.
- 讨论新的OSA指标 (ODI,HB,VB) 和内分类表型.
主要成果:
- 在PH患者的睡眠研究中仅依靠症状就错过了OSA检测.
- 目前的指标,如呼吸暂停-呼吸暂停指数 (AHI),对PH风险缺乏明确性.
- 新的指标和家庭睡眠研究 (HST) 可能会改善OSA检测和PH的风险分层.
结论:
- 在PH患者中早期发现OSA对于预防不良结果至关重要.
- 需要进行前性试验来验证ODI,HB和VB的预后作用.
- 考虑HST而不是OPO,甚至在PH患者中对轻度OSA进行PAP治疗.
相关概念视频
Sleep Apnea
148
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
148
Pulmonary Hypertension: Classification and Pathogenesis
173
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
173
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
199
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
199
Other Pulmonary Disorders
836
Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
836
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
150
Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
150
Measurement of Blood Pressure
924
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
924


