title: [Severe obstructive sleep apnea-hypopnea syndrome with dilated cardiomyopathy leading to pulmonary hypertension: case report and literature review].
abstract: Objective:To study the relationship between dilated cardiomyopathy and obstructive sleep apnea-hypopnea syndrome (OSAHS) and to evaluate the curative effects of continuous positive airway pressure (CPAP) in OSAHS complicated with dilated cardiomyopathy.Methods:We reported one case with the symptom of exertional dyspnea for 1 year and aggravating for 1 month. The patient finally was diagnosed with severe OSAHS complicated with dilated cardiomyopathy leading to pulmonary hypertension. A systematic literature review was performed for similar published cases in Pubmed, Wanfang and CNKI database, using the keywords (obstructive sleep apnea) OR(OSA) OR(OSAHS) AND(dilated cardiomyopathy OR DCM)from January 1990 to May 2016.Results:Our patient had no significant improvement after receiving initial treatments, including reducing cardiac preload, improving myocardial metabolism, increasing myocardial contractility, and anticoagulants. After the patient was diagnosed as having severe OSAHS by polysomnography(PSG) and treated with CPAP, his symptoms improved remarkably. The enlarged heart became smaller and the patient had no repeated dyspnea at follow-up examination. By literature review, we found 4 English original articles and 6 Chinese articles (1 review article, 1 expert note, 1 original article and 3 case reports) on OSAHS complicated by DCM.Four Chinese and 1 English articles reported that the symptoms and parameters of OSAHS with DCM was improved remarkably after treatment with CPAP.Conclusion:For patients with dilated cardiomyopathy which fails to conventional therapy, especially those accompanied by obesity, snoring, daytime sleepiness, morning dry mouth and other related symptoms, PSG should be carried out. Early CPAP therapy could improve symptoms and prognosis of OSAHS associated with DCM.
authors.affiliation: State Key Laboratory of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Diseases, National Research Center of Clinical Medicine, Guangzhou 510120, China.
authors.forename: R K
authors.initials: RK
authors.lastname: Chen
authors.forename: C
authors.initials: C
authors.lastname: Hong
authors.forename: Y M
authors.initials: YM
authors.lastname: Zhou
authors.forename: A L
authors.initials: AL
authors.lastname: Kuang
authors.forename: Y T
authors.initials: YT
authors.lastname: Zhang
authors.forename: S M
authors.initials: SM
authors.lastname: Qing
authors.forename: C L
authors.initials: CL
authors.lastname: Liu
authors.forename: N F
authors.initials: NF
authors.lastname: Zhang
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012894:Sleep Stages; D012913:Snoring; D016896:Treatment Outcome
keywords: Cardiomyopathy, dilated; Continuous positive airway pressure; Hypertension, pulmonary; Sleep apnea syndrome, obstructive