Source: Annual Congress 2003 - Pulmonary hypertension
Disease area: Pulmonary vascular diseases, Sleep and breathing disorders

Abstract

Periodic breathing or Cheyne-Stokes (CS) pattern during sleep is common during left ventricular failure and is associated with a poor prognosis independently of LVEF. In 23 consecutive patients with PPH, we prospectively looked at prevalence of CS pattern and its prognostic significance. Patients underwent pulmonary function tests (PFT), arterial blood gases, measurement of quality of life with Chronic Respiratory Questionnaire (CRQ), 6 min walking distance (6MWD), right heart catheterization and polygraphic recordings of sleep related respiratory disorders (SRRD). They were 56±15.1 yr. old, BMI: 24.6±6.1, FVC: 90.6±18.6%, FEV₁: 81.7±20.3%, TLC: 96.9±20.9% pred., PaO₂: 8.1±1.9, PaCO₂: 4.4±0.7 kPa, 6MWD: 295±120 meters, CRQ, dyspnea: 14.6±4.1 [5-35], fatigue: 13.9±6 [4-28], emotional function: 26.7±8 [7-49], symptoms: 16.1±5.2 [4-28], cardiac output: 4.2±1 l/min, pulmonary systolic pressure: 80±27 mm Hg, pulmonary arterial resistance: 925±490 din.sec^-1.cm^-5. Out of 23, 11 had no SRRD, 5 exhibited central sleep apnea syndrome (> 15 apnea-hypopnea / h) and 7 obstructive sleep apnea syndrome; 13 had no CS, 10 had a CS pattern during sleep. They were no significative difference regarding baseline PFTs, blood gases, 6MWD, CRQ scores or right hemodynamics between these subgroups. Our main results concern a significant difference in median survival of 70 months in patients without CS as opposed to 35 months in patients with a CS (p: 0.03). We conclude that SRRDs are common in patients with PPH and CS pattern should be systematically looked for in PPH patients considering its high prognostic value.

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Citations should be made in the following way:
C. Pison, N. Chouri, F. Felix, B. Coltey, R. Hamidfar, J. L. Pepin (Grenoble, France). Prognostic value of periodic breathing in primary pulmonary hypertension (PPH). Eur Respir J 2003; 22: Suppl. 45, 3532

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