Endothelin-1 levels in interstitial lung disease patients during sleep.

被引：27
作者：
Georgia Trakada
Eugenia Nikolaou
Athanasia Pouli
Maria Tsiamita
Kostas Spiropoulos
机构：
[1] University of Patras Medical School, Division of Pulmonology, Laboratory of Sleep, Patras
来源：
Sleep and Breathing | 2003年 / 7卷 / 3期
关键词：
Interstitial lung disease; sleep; endothelin-1 (ET-1); hypoxemia;
D O I：
10.1007/s11325-003-0111-y
中图分类号：
学科分类号：
摘要：
BACKGROUND: Hypoxemia stimulates endothelin-1 (ET-1) secretion. The reduction in alveolar ventilation during sleep is considered sufficient to account for the hypoxemia observed in patients with respiratory diseases. OBJECTIVE: The aim of this study was to evaluate the arterial ET-1 levels and their relationship with pulmonary hypertension in patients with interstitial lung disease (ILD) during sleep. METHODS: We examined 38 patients with ILD using formal polysomnography (electroencephalogram, electrocardiogram, airflow, respiratory muscle movement, oximeter) to detect the presence of nocturnal, nonapneic, oxyhemoglobin desaturation. All patients desaturated below a baseline sleep saturation of 90% for 5 minutes or more, reaching a nadir saturation of at least 85%. Each patient had already undergone right heart catheterization with a Swan-Ganz catheter for measuring hemodynamic parameters. Sampling of arterial blood from a radial artery line for determination of blood gases and ET-1 values was performed simultaneously, after 5 minutes of the first desaturation. RESULTS: At rest, arterial ET-1 levels were higher in ILD patients (1.73 +/- 0.37 mgr/mL) than in controls (1.22 +/- 0.15 mgr/mL) ( p < 0.001). Also, the patients with pulmonary hypertension (Pa > 20 mm Hg) presented significantly higher arterial ET-1 levels (1.86 +/- 0.32 mgr/mL) than those without pulmonary hypertension (1.31 +/- 0.13 mgr/mL) ( p < 0.001). Arterial ET-1 levels were significantly correlated with mean pulmonary arterial pressure (PAP) (r = 0.749, p < 0.001), and arterial oxygen partial pressure (PaO2) (r = 0.79, p < 0.001). At sleep, during desaturation, arterial ET-1 levels significantly increased in all patients (2.46 +/- 0.13 mgr/mL) as compared with resting values ( p < 0.001). Arterial ET-1 levels were significantly correlated with PAP (r = 0.657, p < 0.001) and PaO2 (r = 0.93, p < 0.001). CONCLUSIONS: According to our study, arterial ET-1 is markedly increased in ILD patients, especially in those with pulmonary hypertension.
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页码：111 / 118
页数：7
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