[Obstructive sleep apnea-hypopnea syndrome in patients with pulmonary thromboembolism: clinical features and management].

OBJECTIVE: To describe the clinical features of obstructive sleep apnea-hypopnea syndrome (OSAHS) in hospitalized pulmonary thromboembolism (PTE) patients, and to explore its impact on the severity of disease and management among patients with PTE. METHODS: Demographic and clinical characteristics of 28 PTE patients complicated with OSAHS admitted to this hospital from January 2002 to December 2010 were analyzed. A total of 30 PTE patients without OSAHS served as a control group. RESULTS: PTE patients with OSAHS had a significantly lower age of onset of disease [(55 ± 11) yr vs (66 ± 11) yr, t = 3.230, P < 0.01], an increased body mass index (BMI) [(30.1 ± 2.8) kg/m(2) vs (26.1 ± 3.1) kg/m(2), t = -4.161, P < 0.001] and a higher smoking index [(19 ± 6) packs/yr vs (8 ± 4) packs/yr, t = -1.713, P < 0.05] when compared with PTE patients without OSAHS. PaO2 [(70 ± 8) mm Hg vs (79 ± 6) mm Hg, 1 mm Hg = 0.133 kPa, t = 4.233, P < 0.05] and involved lung segments [(8 ± 4) vs (5 ± 3), t = -2.496, P < 0.05] in PTE patients with OSAHS were more severe than those in PTE patients without OSAHS. All patients received anticoagulation and/or thrombolysis treatment, and continuous positive airway pressure (CPAP) ventilation was used in some PTE patients with OSAHS. CONCLUSION: PTE patients with OSAHS had a significantly earlier age of onset of disease and more severe conditions than PTE patients without OSAHS. Treatments including anticoagulation and CPAP should be used in these patients.

Obstructive sleep apnoea risk profile and the risk of recurrence of atrial fibrillation after catheter ablation.

AIMS: The aim of this study was to identify the impact of obstructive sleep apnoea (OSA) on recurrence after catheter ablation of paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: One hundred and seventy-eight consecutive patients with paroxysmal AF who underwent index circumferential pulmonary vein (PV) isolation were prospectively enrolled. The patients were divided into high risk (HR group) and low risk (LR group) for OSA group with Berlin questionnaire. Of the 178 patients, 104 (58.4%) were in the HR group and 74 (41.6%) were in the LR group. After a mean follow-up of 344 +/- 137 (91-572) days, 44 patients (24.7%) experienced recurrence, and the recurrence rate did not differ between the HR (25.0%) and LR groups (24.3%, P = 0.855). Cox analysis revealed that PV isolation was the only independent predictor of recurrence (hazard ratio 5.11, 95% confidence interval 1.42-18.47, P = 0.013). There was no significant difference in the incidence of complications between the HR and LR groups (2.9 vs. 1.9%, P = 0.729). CONCLUSION: The recurrence rate and incidence of complications did not differ in patients with different risk profiles for OSA. The presence of OSA should not lower the decision threshold to choose an ablative procedure in paroxysmal AF.

[Expression of various matrix metalloproteinases in mice with hyperoxia-induced acute lung injury].

OBJECTIVE: To investigate the role of matrix metalloproteinases (MMPs) and extracellular matrix metalloproteinase inducer (EMMPRIN) in the pathogenesis of acute lung injury induced by hyperoxia. METHODS: Fifty four mice were exposed in sealed cages to >98% oxygen (for 24-72 hours), and another 18 mice to room air. The severity of lung injury was assessed, and the expression of mRNA and protein of MMP-2, MMP-9 and EMMPRIN in lung tissue, after exposure for 24, 48 and 72 hours of hyperoxia were studied by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. RESULTS: Hyperoxia caused acute lung injury; this was accompanied by increased expression of an upregulation of MMP-2, MMP-9 and EMMPRIN mRNA and protein in lung tissues. CONCLUSION: Hyperoxia causes acute lung injury in mice; increases in MMP-2, MMP-9 and EMMPRIN may play an important role in the development of hyperoxia induced lung injury in mice.