BACKGROUND: Nocturnal desaturation may contribute to long-term pulmonary vascular stress in interstitial lung disease (ILD). We study the prevalence, severity and prognostic utility of nocturnal desaturation across ILD. METHODS: ILD patients with overnight oximetry (June 2006-August 2008) were reviewed (n = 134). Significant nocturnal desaturation was considered as > 10% of sleep with SpO2 < 90%. Desaturation index (DI) was defined as the number of desaturation events > 4%/hr. Covariates, including indices of nocturnal desaturation, were evaluated against mortality. RESULTS: Nocturnal desaturation was present in 49 (37%) patients. 31% of patients had pulmonary hypertension (PH) on echocardiography. Increased DI was associated with higher mortality independent of age, gender and BMI (HR 1.04; 95% CI 1.00, 1.06; p = 0.009). In separate models, DI and a) elevated brain natriuretic peptide (BNP; HR 1.04; 95% CI 1.00, 1.08; p = 0.04); b) moderate-severe PH on echocardiography (HR 3.15; 95% CI 1.24, 8.00; p = 0.02); and c) daytime resting SpO2 (HR 0.92; 95% CI 0.85, 0.99; p = 0.04) independently predicted mortality following adjustment for age, gender and BMI. CONCLUSION: Nocturnal desaturation is common and may be severe in ILD. Elevated nocturnal DI predicts higher mortality across ILD, independent of other vascular parameters. This finding may have important implications for the pathogenesis of PH in IPF.
BACKGROUND: Nocturnal desaturation may contribute to long-term pulmonary vascular stress in interstitial lung disease (ILD). We study the prevalence, severity and prognostic utility of nocturnal desaturation across ILD. METHODS:ILDpatients with overnight oximetry (June 2006-August 2008) were reviewed (n = 134). Significant nocturnal desaturation was considered as > 10% of sleep with SpO2 < 90%. Desaturation index (DI) was defined as the number of desaturation events > 4%/hr. Covariates, including indices of nocturnal desaturation, were evaluated against mortality. RESULTS: Nocturnal desaturation was present in 49 (37%) patients. 31% of patients had pulmonary hypertension (PH) on echocardiography. Increased DI was associated with higher mortality independent of age, gender and BMI (HR 1.04; 95% CI 1.00, 1.06; p = 0.009). In separate models, DI and a) elevated brain natriuretic peptide (BNP; HR 1.04; 95% CI 1.00, 1.08; p = 0.04); b) moderate-severe PH on echocardiography (HR 3.15; 95% CI 1.24, 8.00; p = 0.02); and c) daytime resting SpO2 (HR 0.92; 95% CI 0.85, 0.99; p = 0.04) independently predicted mortality following adjustment for age, gender and BMI. CONCLUSION: Nocturnal desaturation is common and may be severe in ILD. Elevated nocturnal DI predicts higher mortality across ILD, independent of other vascular parameters. This finding may have important implications for the pathogenesis of PH in IPF.
Authors: Jingjing Liang; Brian E Cade; Karen Y He; Heming Wang; Jiwon Lee; Tamar Sofer; Stephanie Williams; Ruitong Li; Han Chen; Daniel J Gottlieb; Daniel S Evans; Xiuqing Guo; Sina A Gharib; Lauren Hale; David R Hillman; Pamela L Lutsey; Sutapa Mukherjee; Heather M Ochs-Balcom; Lyle J Palmer; Jessica Rhodes; Shaun Purcell; Sanjay R Patel; Richa Saxena; Katie L Stone; Weihong Tang; Gregory J Tranah; Eric Boerwinkle; Xihong Lin; Yongmei Liu; Bruce M Psaty; Ramachandran S Vasan; Michael H Cho; Ani Manichaikul; Edwin K Silverman; R Graham Barr; Stephen S Rich; Jerome I Rotter; James G Wilson; Susan Redline; Xiaofeng Zhu Journal: Am J Hum Genet Date: 2019-10-24 Impact factor: 11.025
Authors: Brian E Cade; Han Chen; Adrienne M Stilp; Tin Louie; Sonia Ancoli-Israel; Raanan Arens; Richard Barfield; Jennifer E Below; Jianwen Cai; Matthew P Conomos; Daniel S Evans; Alexis C Frazier-Wood; Sina A Gharib; Kevin J Gleason; Daniel J Gottlieb; David R Hillman; W Craig Johnson; David J Lederer; Jiwon Lee; Jose S Loredo; Hao Mei; Sutapa Mukherjee; Sanjay R Patel; Wendy S Post; Shaun M Purcell; Alberto R Ramos; Kathryn J Reid; Ken Rice; Neomi A Shah; Tamar Sofer; Kent D Taylor; Timothy A Thornton; Heming Wang; Kristine Yaffe; Phyllis C Zee; Craig L Hanis; Lyle J Palmer; Jerome I Rotter; Katie L Stone; Gregory J Tranah; James G Wilson; Shamil R Sunyaev; Cathy C Laurie; Xiaofeng Zhu; Richa Saxena; Xihong Lin; Susan Redline Journal: PLoS Genet Date: 2019-04-16 Impact factor: 5.917