[Comparison of pulmonary hemodynamics in patients with COPD and patients with overlap syndrome with similar severity of airway obstruction and gas exchange].
It may be assumed that pulmonary hypertension due to apnea related desaturations during sleep develops earlier in the natural course of the overlap syndrome (OS) than in patients with COPD only. We aimed to verify this hypothesis by comparing pulmonary haemodynamics in COPD patients and patients with OS with similar severity of airway limitation and of pulmonary gas exchange. We studied pulmonary haemodynamics in 17 males with OS--group I (mean AHI 63.9 +/- 18.9), and in 20 males with COPD--group II. Both groups were age (I = 51.4 +/- 8.3 years, II = 53.7 +/- 7.7 years), FVC (I = 2.7 +/- 0.7 L, II = 2.9 +/- 0.6 L), FEV1 (I = 1.5 +/- 0.7 L, II = 1.3 +/- 0.3 L), PaO2 (I = 56.9 +/- 9.5 mm Hg, II = = 61.7 +/- 14.6 mm Hg) and PaCO2 (I = 46.9 +/- 9.8 mm Hg, II = 48.3 +/- 6.6 mm Hg) matched. Haemodynamic measurements were performed at rest and in 7th minute of exercise if 40 Watts using Swan-Ganz thermodilution catheter. Both groups presented with similar severity of pulmonary hypertension at rest (mean PPA = 24.2 +/- 7.4 mm Hg in OS and 24.3 +/- 9.2 mm Hg in COPD) and on exercise (mean PPA 41.2 +/- 15.1 mm Hg in OS and 44.5 +/- 11.5 mm Hg in COPD). COPD patients had higher PVR than OS (335 +/- 138 d.s.cm-5 versus 229 +/- 97 d.s.cm-5, p < 0.005). We concluded that pulmonary hypertension in OS patients is not more advanced than in COPD patients with matched ventilatory and gas exchange impairment.
Hawryłkiewicz
I
I
Klinika Chorób Płuc, Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Pałasiewicz
G
G
Pływaczewski
R
R
Sliwiński
P
P
Zieliński
J
J
D000402:Airway Obstruction / Q000175:diagnosis; D001784:Blood Gas Analysis; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D008173:Lung Diseases, Obstructive / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*