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In the investigators study, and regarding results of small cohorts in the literature, the investigators hypothesize that hypoxemia is frequent in IPAH and CPEPH. The investigators will explore these patients with a one night polysomnography and transcutaneous capnography, searching for hypoxemia and hypercapnia and by determining its physiopathologic mechanisms.
Pulmonary hypertension (PH) is a rare and severe disease of young adults, characterized by a progressive increase in pulmonary vascular resistances leading to cardiac failure and death. Patients with PH are categorized in two major groups: primary PH (PPH) wich is idiopathic, and secondary PH associated with many conditions such as chronic pulmonary embolic diseases (CPED).Increase in vascular resistance in PH is secondary to vasoconstriction and to a proliferative remodeling process of the arterial wall leading to obliteration of the small arterioles. On the other hand, hypoxemia is known to cause similar changes in vascular architecture. Also, some small cohorts study in the literature mentioned an increase of sleep hypoxemia prevalence accounting for almost 70% of cases. The mechanisms of this hypoxemia are completely unknown.Our study is observational, prospective and transversal, searching for hypoxemic respiratory sleep disorders (HRSD) in PPH and in CPEPH. Included patients will have one night polysomnography (CIDELEC) with a continuous measurement of transcutaneous PCO2.The major objectives are to determine the prevalence of HRSD, their physiopathologic mechanisms and their possible causal factors according to PH history, clinical findings and hemodynamic severity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IPAH or CPEPH | Idiopathic pulmonary arterial hypertension (IPAH) or pulmonary hypertension associated with chronic post-embolic pulmonary hypertension (CPEPH) |
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| Measure | Description | Time Frame |
|---|---|---|
| hypoxemia during the night | prevalence of nocturnal hypoxemia in IPAH and CPEPH | at the inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Predictors: physical, functional and hemodynamical data | Predictive factors of sleep hypoxemia in IPAH and CPEPH | at the inclusion |
| Physiopathologic mechanisms: causes of nocturnal hypoxemia: hypoventilation, sleep disordered breathing, shunting, V/Q mismatch |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with IPAH or CPEPH hospitalized in our pulmonary department for a standard follow-up. They have to be in a stable condition, as defined by the New York Heart Association classes for dyspnea and the six minutes walking test. Furthermore, no changes in medical therapy could have been made during the last three months.
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| Name | Affiliation | Role |
|---|---|---|
| Gabriel ROISMAN, MD | Assistance Publique - Hopitaux de Paris, Hôpital Antoine Beclere | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assistance Publique- Hôpitaux de Paris: Antoine Beclere Hospital | Clamart | 92141 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22878784 | Derived | Jilwan FN, Escourrou P, Garcia G, Jais X, Humbert M, Roisman G. High occurrence of hypoxemic sleep respiratory disorders in precapillary pulmonary hypertension and mechanisms. Chest. 2013 Jan;143(1):47-55. doi: 10.1378/chest.11-3124. |
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| ID | Term |
|---|---|
| D012893 | Sleep Wake Disorders |
| D000081029 | Pulmonary Arterial Hypertension |
| D012891 | Sleep Apnea Syndromes |
| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Physiopathologic mechanisms of sleep hypoxemia in IPAH and CPEPH |
| at the inclusion |
| D001523 | Mental Disorders |
| D006976 | Hypertension, Pulmonary |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |