A clue for obstructive sleep apnea hidden in tomographic images of idiopathic pulmonary fibrosis patients

Authors : Sezgi ŞAHİN DUYAR, Hakan ERTÜRK, Selma FIRAT, Deniz ÇELİK

Pages : 584-592

Doi:10.18621/eurj.768970

View : 21 | Download : 8

Publication Date : 2021-11-04

Article Type : Research Paper

Abstract :Objectives: The most common opinion about apnea/hypopnea formation in restrictive pulmonary diseases is based on decreased lung volumes causing upper airway collapse. This study targets to reveal some evidence for this pathophysiological pathway in patients with idiopathic pulmonary fibrosis insert ignore into journalissuearticles values(IPF); and obstructive sleep apnea insert ignore into journalissuearticles values(OSA);. Methods: The clinical, demographical, and polysomnographic characteristics of 19 patients with OSA and IPF who underwent all-night polysomnography insert ignore into journalissuearticles values(PSG); were retrospectively evaluated for investigating the correlations between lung volumes calculated on the images of high-resolution computed tomography insert ignore into journalissuearticles values(HRCT); and polysomnographic findings. Supine HRCT images performed at the time of diagnosis of IPF were used for the calculation of total lung volume and low attenuation areas of the lung insert ignore into journalissuearticles values(LAA);. The results were compared with the results of the PSG and pulmonary function tests insert ignore into journalissuearticles values(PFT);. Results: The study group comprised 19 patients insert ignore into journalissuearticles values(3 female, 16 male); with a median apnea-hypopnea index insert ignore into journalissuearticles values(AHI); of 23.5/h. AHI in this IPF cohort was not correlated with body-mass index, neck circumference, age, or PFT. However, overall AHI and non-rapid eye movement insert ignore into journalissuearticles values(non-REM); AHI had a trend of positive correlation with LAA. We also showed a positive correlation between the LAA and forced vital capacity insert ignore into journalissuearticles values(FVC); insert ignore into journalissuearticles values(r=0.682 and, p = 0.003);. Conclusions: The severity of OSAS in IPF patients is well correlated with LAA. This result supports the gravitational and the volumetric effect of the lung in apnea-hypopnea formation.
Keywords : idiopathic pulmonary fibrosis, low attenuation areas of the lung, obstructive sleep apnea, pulmonary function tests, quantitative imaging