Nocturnal hypoxemia and high circulating TNF-alpha levels in chronic thromboembolic pulmonary hypertension
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- Naito Akira
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Sakao Seiichiro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Terada Jiro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Iwasawa Shunichiro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Jujo Sanada Takayuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Suda Rika
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Kasai Hajime
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Sekine Ayumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Nishimura Rintaro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Sugiura Toshihiko
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Shigeta Ayako
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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- Tanabe Nobuhiro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan Pulmonary Hypertension Center, Chibaken Saiseikai Narashino Hospital, Japan
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- Tatsumi Koichiro
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
書誌事項
- タイトル別名
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- Nocturnal Hypoxemia and High Circulating TNF-α Levels in Chronic Thromboembolic Pulmonary Hypertension
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抄録
<p>Objective Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary hypertension caused by persistent thromboemboli of the pulmonary arteries, and one of its etiological factors may be inflammation. Sleep disordered breathing (SDB) is reportedly an important complication of pulmonary hypertension. However, the association between SDB and inflammation in CTEPH has been undefined. This prospective observational study analyzed the association between the severity of SDB, pulmonary hemodynamic parameters and the systemic inflammation level in patients with CTEPH. </p><p>Methods CTEPH patients admitted for a right heart catheter (RHC) examination were consecutively enrolled from November 2017 to June 2019 at the pulmonary hypertension center in Chiba University Hospital. Patients with idiopathic pulmonary arterial hypertension (IPAH) were also enrolled as a control group. All patients underwent a sleep study using a WatchPAT 200 during admission. </p><p>Results The CTEPH patients showed worse nocturnal hypoxemia, oxygen desaturation index (ODI), and apnea-hypopnea index than the IPAH patients. Among these factors, only the nocturnal mean percutaneous oxygen saturation (SpO2) was negatively correlated with the pulmonary hemodynamic parameters. The circulating tumor necrosis factor-alpha (TNF-α) level was also high in the CTEPH group, and a multivariate analysis showed that the nocturnal mean SpO2 was the most important predictive factor for a high TNF-α level. </p><p>Conclusion We showed that CTEPH patients had high serum TNF-α levels and that the nocturnal mean SpO2 was a predictive factor for serum TNF-α levels. Further investigations focused on nocturnal hypoxemia and the TNF-α level may provide novel insight into the etiology and new therapeutic strategies for CTEPH. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 59 (15), 1819-1826, 2020-08-01
一般社団法人 日本内科学会
