Cardiopulmonary pathology in patients with sleep apnea/obesity hypoventilation syndrome
Abstract
We reviewed clinical data, autopsy reports, and microscopic slides on 10 patients with sleep apnea/obesity hypoventilation syndrome (SA/OHS) to define the cardiopulmonary pathological features and establish clinicopathologic correlations. Ten obese (>136 kg) patients without SA/OHS were studied as controls. Patients with SA/OHS exhibited biventricular cardiac failure and pulmonary hypertension with a higher prevalence of moderate/severe pulmonary hemosiderosis (8 v 0 patients), alveolar hemorrhage (7 v 4 patients), capillary proliferation (4 v 0 patients), iron encrustation of elastica (1 v 0 patients) and medial hypertrophy of muscular pulmonary arteries (11.9 +/- 2.4 v 9.7 +/- 1.6%) (P < .05). In two patients capillary proliferation resembled capillary hemangiomatosis. Mean right ventricular thickness was higher in the SA/OHS group (0.71 +/- 0.17 v 0.42 +/- 0.1 cm) (P < .01). Four patients with SA/OHS and three controls had moderate/severe myocardial fibrosis. Biventricular cardiac failure caused death in seven patients with SA/OHS. Hypoxia is probably the most important cause of pulmonary hypertension, arterial muscularization, and right ventricular hypertrophy in SA/ OHS. Left ventricular failure in some SA/OHS patients may be the result of hypertensive cardiac disease. In others, the etiology of left ventricular failure was not determined morphologically, suggesting functional abnormalities related to obesity and/or apneic episodes.
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Autopsy series have shown cardiac hypertrophy plus a variable extent of coronary artery disease in obese and nonobese subjects.
“However, autopsy series present the opportunity to study heart tissue from obese and nonobese subjects, and in general, these studies have shown cardiac hypertrophy plus a variable extent of coronary artery disease (9, 64, 91, 147, 185–188, 300).”
From Cardiac remodeling in obesity (2008) · cites this paper as [9]
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- Authors
- Ahmed, Q., Chung-Park, M., & Tomashefski, J. F.
- Affiliations
- MetroHealth (US)
- Corresponding author
- Tomashefski, Joseph F
- Venue
- Human Pathology
- Publisher
- Elsevier BV
- Published
- 1997-03
- Volume
- 28
- Issue
- 3
- Pages
- 264-269
- ISSN
- 0046-8177 (ISSN-L)
- OpenAlex
- W2046942152
- Cited by
- 73
- References
- 31
- Citations by year
- 2024: 3 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 2 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Keywords
- pulmonary hypertension, pulmonary hemosiderosis, alveolar hemorrhage, capillary proliferation, right ventricular hypertrophy, myocardial fibrosis, hypoxia, obesity, autopsy findings
- MeSH terms
- Adult, Aged, Female, Hemosiderosis, Humans, Lung, Male, Middle Aged, Myocardium, Obesity, Retrospective Studies, Sleep Apnea Syndromes
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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