Overnight desaturation in interstitial lung diseases: links to pulmonary vasculopathy and mortality

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  • dc.contributor.author Margaritopoulos, George A.
  • dc.contributor.author Proklou, Athanasia
  • dc.contributor.author Trachalaki, Athina
  • dc.contributor.author Badenes Bonet, Diana, 1987-
  • dc.contributor.author Kokosi, Maria
  • dc.contributor.author Kouranos, Vasilis
  • dc.contributor.author Chua, Felix
  • dc.contributor.author George, Peter
  • dc.contributor.author Renzoni, Elisabetta A.
  • dc.contributor.author Devaraj, Anand
  • dc.contributor.author Desai, Sujal
  • dc.contributor.author Nicholson, Andrew G.
  • dc.contributor.author Antoniou, Katerina M.
  • dc.contributor.author Wells, Athol U.
  • dc.date.accessioned 2024-10-14T06:27:59Z
  • dc.date.available 2024-10-14T06:27:59Z
  • dc.date.issued 2024
  • dc.description.abstract Background: Overnight desaturation predicts poor prognosis across interstitial lung diseases (ILDs). The aim of the present study was to investigate whether nocturnal desaturation is associated with pulmonary vasculopathy and mortality. Methods: A retrospective single centre study of 397 new ILD patients was carried out including patients with idiopathic pulmonary fibrosis (IPF) (n=107) and patients with non-IPF fibrotic ILD (n=290). This is the largest study to date of the effect of significant nocturnal desaturation (SND) (≥10% of total sleep time with oxygen saturation ≤90% measured by pulse oximetry). Results: The prevalence of SND was 28/107 (26.2%) in IPF and 80/290 (27.6%) in non-IPF ILD. The prevalence of SND was higher in non-IPF ILDs than in IPF (p=0.025) in multivariate analysis. SND was associated with noninvasive markers of pulmonary hypertension (PH): tricuspid regurgitation velocity (TRV) (p<0.0001), brain natriuretic peptide (p<0.007), carbon monoxide transfer coefficient (p<0.0001), A-a gradient (p<0.0001), desaturation >4% in 6-min walking test (p<0.03) and pulmonary artery diameter (p<0.005). SND was independently associated with high echocardiographic PH probability in the entire cohort (OR 2.865, 95% CI 1.486-5.522, p<0.002) and in non-IPF fibrotic ILD (OR 3.492, 95% CI 1.597-7.636, p<0.002) in multivariate analysis. In multivariate analysis, SND was associated with mortality in the entire cohort (OR 1.734, 95% CI 1.202-2.499, p=0.003) and in IPF (OR 1.908, 95% CI 1.120-3.251, p=0.017) and non-IPF fibrotic ILD (OR 1.663, 95% CI 1.000-2.819, p=0.041). Separate models with exclusion of each one of the diagnostic subgroups showed that no subgroup was responsible for this finding in non-IPF ILDs. SND was a stronger marker of 5-year mortality than markers of PH. Conclusion: SND was associated with high echocardiographic probability and mortality and was a stronger predictor of mortality in IPF and non-IPF ILDs grouped together to power the study.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Margaritopoulos GA, Proklou A, Trachalaki A, Badenes Bonet D, Kokosi M, Kouranos V, et al. Overnight desaturation in interstitial lung diseases: links to pulmonary vasculopathy and mortality. ERJ Open Res. 2024 Feb 12;10(1):00740-2023. DOI: 10.1183/23120541.00740-2023
  • dc.identifier.doi http://dx.doi.org/10.1183/23120541.00740-2023
  • dc.identifier.issn 2312-0541
  • dc.identifier.uri http://hdl.handle.net/10230/61378
  • dc.language.iso eng
  • dc.publisher European Respiratory Society
  • dc.relation.ispartof ERJ Open Res. 2024 Feb 12;10(1):00740-2023
  • dc.rights Copyright © The authors 2024. This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0 (http://creativecommons.org/licenses/by-nc/4.0/). For commercial reproduction rights and permissions contact permissions@ersnet.org
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.subject.other Pulmons--Malalties
  • dc.title Overnight desaturation in interstitial lung diseases: links to pulmonary vasculopathy and mortality
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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