RETRACTED: Anatomic and physiologic predictors of apnea severity in morbidly obese subjects (Retracted article. See vol. 32, pg. 445, 2009)

被引:46
作者
Fogel, RB
Malhotra, A
Dalagiorgou, G
Robinson, MK
Jakab, M
Kikinis, R
Pittman, SD
White, DP
机构
[1] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Radiol, Boston, MA 02115 USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Surg, Boston, MA 02115 USA
[3] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med,Div Sleep Med, Boston, MA 02115 USA
[4] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med,Div Pulm Crit Care, Boston, MA 02115 USA
来源
SLEEP | 2003年 / 26卷 / 02期
关键词
obesity; upper airway; genioglossus; airway vollapse;
D O I
10.1093/sleep/26.2.150
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Objectives: While obesity is the most common risk factor for the development of obstructive sleep apnea, the correlation between measures of obesity and apnea severity is only moderate, We thus attempted to identify anatomic and physiologic predictors of apnea severity. Design: We combined a careful assessment of upper airway anatomy, upper airway physiology, and ventilatory control in a group of obese individuals to identify predictors of apnea severity. Setting: Tertiary care academic medical center. Patients: 14 morbidly obese subjects being evaluated for weight-reduction surgery. Interventions: N/A Measurement and Results: We found no relationship between obesity (weight or body mass index) and apnea severity (respiratory disturbance index, RDI). However, those with severe apnea (RDI > 30) were found to have higher peak genioglossus EMG (GGEMG) (23.5 +/- 1.9 vs. 14.1 +/- 3.7 %max, p = 0.05) and greater airway collapsibility during pulses of negative pressure (7.6 +/- 0.9 vs. 4.4 +/-0.7 cmH(2)O, p =0.02). Airway collapsibility was significantly associated with RDI (r = 0.62, p < 0.01) as was peak GGEMG (r = 0.55, p < 0.05). Of the anatomic variables airway shape (A-P/lateral ratio) and volume change of the pharyngeal airway between total lung capacity and residual volume were different between those with and without severe apnea. Both correlated with RDI (A-P/lateral ratio: r= 0.70, p < 0.01 and volume change: r = 0,77, p < 0.01). Conclusions: We believe these findings suggest that specific anatomic and physiologic properties of the airway interact with obesity to predispose to the development of airway collapse during sleep.
引用
收藏
页码:150 / 155
页数:6
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