+
MODEL
Respiratory Medicine (2015) xx, 1e14
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/rmed
6-Min walk-test data in severe obstructivesleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment* Helmi Ben Saad a,b,c,*,1, Ikram Ben Hassen d,1, Ines Ghannouchi b,c, Imed Latiri c, Sonia Rouatbi b,c, Pierre Escourrou e, Halima Ben Salem d, Mohamed Benzarti d,2, Ahmed Abdelghani a,d,2 a Research Laboratory LR14ES05: Interaction of the Cardiorespiratory System, Faculty of Medicine of Sousse, Sousse, Tunisia b Laboratory of Physiology, Faculty of Medicine, University of Sousse, Tunisia c Department of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia d Pulmonary Department, Farhat HACHED Hospital, Sousse, Tunisia e Laboratory of Functional Exploration, Hospital Antoine Be´cle`re, Clamart, France
Received 24 December 2014; accepted 3 March 2015
KEYWORDS Obstructive-sleepapnea;
Summary Introduction: Few studies have evaluated the functional capacity of severe OSAHS. Aims: To assess their functional capacity, identify their 6-min walking-distance (6MWD) influencing factors and compare their data with those of two control-groups.
Abbreviations: AHI, apnea-hypopnea-index; ATS, American-Thoracic-Society; BMI, body-mass-index; COPD, chronic-obstructive-pulmonarydisease; CPAP, continuous-positive-airway-pressure; DBP, diastolic-blood-pressure; end, at the end of the 6MWT; ENT, ear, nose and throat; FEV1, first-second-forced-expiratory-volume; FVC, forced-vital-capacity; Hr, heart-rate; HrR, heart-rate recovery; ICSD, internationalclassification-of-sleep-disorders; LLN, lower-limit-of-normal; MID, minimal-important-difference; MMEF, maximal-mid-expiratory-flow; NY, Narghile-years; NYHA, New-York-Heart-Association; OSAHS, obstructive-sleep-apnea-hypopnea-syndrome; Oxy-sat, oxy-hemoglobin saturation; PEF, peak-expiratory-flow; PY, pack-years; QOL, quality-of-life; r, correlation coefficient; r2, determination coefficient; rest, before the 6MWT; RV, residual-volume; SBP, systolic-blood-pressure; SD, standard-deviation; SVC, slow-vital-capacity; TGV, thoracic-gas-volume; TLC, total-lung-capacity; VAS, visual-analogue-scale; 6MWD, 6-min walking-distance; 6MWT, 6-min walk-test. * The present research data were previously presented as a poster at the ERS Congress (September, 2010, Barcelona, Spain). First author presenting such data: H. Ben Saad. * Corresponding author. Laboratory of Physiology, Faculty of Medicine of Sousse, Rue Mohamed Karoui, Sousse, Tunisia. Tel.: þ216 98697024; fax: þ216 73224899. E-mail address: [email protected] (H. Ben Saad). 1 These authors contributed equally to this work. 2 These authors contributed equally to this work. http://dx.doi.org/10.1016/j.rmed.2015.03.001 0954-6111/ª 2015 Elsevier Ltd. All rights reserved.
Please cite this article in press as: Ben Saad H, et al., 6-Min walk-test data in severe obstructive-sleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment, Respiratory Medicine (2015), http://dx.doi.org/10.1016/ j.rmed.2015.03.001
+
MODEL
2
H. Ben Saad et al. Deficiency; Impairment; Spirometry; Walk-test; Tunisia
Methods: Sixty (42 males) clinically consecutive stable patients with severe OSAHS under CPAP were included. Clinical, Epworth questionnaire, anthropometric, polysomnographic, plethysmographic and 6-min walk-test (6MWT) data were collected. Univariate and multivariate analyses were used to identify the 6MWD influencing factors. Data of a subgroup of severe OSAHS aged 40 Yrs (n Z 49) were compared with those of non-obese (n Z 174) and obese (n Z 55) groups. Results: The means SD of age and apnea-hypopnea-index were, respectively, 49 10 Yr and 62 18/h. The profile of OSAHS patients carrying the 6MWT, was as follows: at the end of the 6MWT, 31% and 25% had, respectively, a high dyspnea (>5/10, visual analogue scale) and a low heart-rate ( 180 mmHg and/or diastolic-blood-pressure (DBP) 100 mmHg); rheumatological or orthopedic diseases making walking uncomfortable; corticosteroid and/or
3 bronchodilator-use and imperfect realization of the 6MWT. Patients with OSAHS had to stop smoking at least 24 h prior to testing.
Data collection and applied definitions Clinical data were gathered from the American-thoracicsociety (ATS) medical [20] and from the Epworth [21] questionnaires. Medical questions were asked in Arabic by a physician (IBH ) with whom patients were familiar. The following data were collected: socioeconomic and schooling levels, personal medical history [mellitusdiabetes, arterial-hypertension, cardiovascular-diseases (heart-failure, cardiac-arrhythmias, angina, myocardialinfarction), signs or respiratory disorders (dyspnea, chronic-bronchitis, COPD, asthma, tuberculosis), ear, nose and throat (ENT) diseases (enlarged tonsils, nasal obstruction, abnormal soft palate), thyroid disease and anemia], surgical [orthopedic and abdominal] obstetrics and gynecology [parity and menopause], medication-use [betablocker, diuretic, corticoid, bronchodilator] and smoking. Parity was introduced in two forms: numerical (unit) and groups [small: 10 was considered abnormal [21]. Smoking data: cigarette-smoking [pack-years (PY)] and narghile-use [narghile-years (NY)] were evaluated. Two groups of smokers were identified [14,17] [Non-smoker (
MODEL
Respiratory Medicine (2015) xx, 1e14
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/rmed
6-Min walk-test data in severe obstructivesleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment* Helmi Ben Saad a,b,c,*,1, Ikram Ben Hassen d,1, Ines Ghannouchi b,c, Imed Latiri c, Sonia Rouatbi b,c, Pierre Escourrou e, Halima Ben Salem d, Mohamed Benzarti d,2, Ahmed Abdelghani a,d,2 a Research Laboratory LR14ES05: Interaction of the Cardiorespiratory System, Faculty of Medicine of Sousse, Sousse, Tunisia b Laboratory of Physiology, Faculty of Medicine, University of Sousse, Tunisia c Department of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia d Pulmonary Department, Farhat HACHED Hospital, Sousse, Tunisia e Laboratory of Functional Exploration, Hospital Antoine Be´cle`re, Clamart, France
Received 24 December 2014; accepted 3 March 2015
KEYWORDS Obstructive-sleepapnea;
Summary Introduction: Few studies have evaluated the functional capacity of severe OSAHS. Aims: To assess their functional capacity, identify their 6-min walking-distance (6MWD) influencing factors and compare their data with those of two control-groups.
Abbreviations: AHI, apnea-hypopnea-index; ATS, American-Thoracic-Society; BMI, body-mass-index; COPD, chronic-obstructive-pulmonarydisease; CPAP, continuous-positive-airway-pressure; DBP, diastolic-blood-pressure; end, at the end of the 6MWT; ENT, ear, nose and throat; FEV1, first-second-forced-expiratory-volume; FVC, forced-vital-capacity; Hr, heart-rate; HrR, heart-rate recovery; ICSD, internationalclassification-of-sleep-disorders; LLN, lower-limit-of-normal; MID, minimal-important-difference; MMEF, maximal-mid-expiratory-flow; NY, Narghile-years; NYHA, New-York-Heart-Association; OSAHS, obstructive-sleep-apnea-hypopnea-syndrome; Oxy-sat, oxy-hemoglobin saturation; PEF, peak-expiratory-flow; PY, pack-years; QOL, quality-of-life; r, correlation coefficient; r2, determination coefficient; rest, before the 6MWT; RV, residual-volume; SBP, systolic-blood-pressure; SD, standard-deviation; SVC, slow-vital-capacity; TGV, thoracic-gas-volume; TLC, total-lung-capacity; VAS, visual-analogue-scale; 6MWD, 6-min walking-distance; 6MWT, 6-min walk-test. * The present research data were previously presented as a poster at the ERS Congress (September, 2010, Barcelona, Spain). First author presenting such data: H. Ben Saad. * Corresponding author. Laboratory of Physiology, Faculty of Medicine of Sousse, Rue Mohamed Karoui, Sousse, Tunisia. Tel.: þ216 98697024; fax: þ216 73224899. E-mail address: [email protected] (H. Ben Saad). 1 These authors contributed equally to this work. 2 These authors contributed equally to this work. http://dx.doi.org/10.1016/j.rmed.2015.03.001 0954-6111/ª 2015 Elsevier Ltd. All rights reserved.
Please cite this article in press as: Ben Saad H, et al., 6-Min walk-test data in severe obstructive-sleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment, Respiratory Medicine (2015), http://dx.doi.org/10.1016/ j.rmed.2015.03.001
+
MODEL
2
H. Ben Saad et al. Deficiency; Impairment; Spirometry; Walk-test; Tunisia
Methods: Sixty (42 males) clinically consecutive stable patients with severe OSAHS under CPAP were included. Clinical, Epworth questionnaire, anthropometric, polysomnographic, plethysmographic and 6-min walk-test (6MWT) data were collected. Univariate and multivariate analyses were used to identify the 6MWD influencing factors. Data of a subgroup of severe OSAHS aged 40 Yrs (n Z 49) were compared with those of non-obese (n Z 174) and obese (n Z 55) groups. Results: The means SD of age and apnea-hypopnea-index were, respectively, 49 10 Yr and 62 18/h. The profile of OSAHS patients carrying the 6MWT, was as follows: at the end of the 6MWT, 31% and 25% had, respectively, a high dyspnea (>5/10, visual analogue scale) and a low heart-rate ( 180 mmHg and/or diastolic-blood-pressure (DBP) 100 mmHg); rheumatological or orthopedic diseases making walking uncomfortable; corticosteroid and/or
3 bronchodilator-use and imperfect realization of the 6MWT. Patients with OSAHS had to stop smoking at least 24 h prior to testing.
Data collection and applied definitions Clinical data were gathered from the American-thoracicsociety (ATS) medical [20] and from the Epworth [21] questionnaires. Medical questions were asked in Arabic by a physician (IBH ) with whom patients were familiar. The following data were collected: socioeconomic and schooling levels, personal medical history [mellitusdiabetes, arterial-hypertension, cardiovascular-diseases (heart-failure, cardiac-arrhythmias, angina, myocardialinfarction), signs or respiratory disorders (dyspnea, chronic-bronchitis, COPD, asthma, tuberculosis), ear, nose and throat (ENT) diseases (enlarged tonsils, nasal obstruction, abnormal soft palate), thyroid disease and anemia], surgical [orthopedic and abdominal] obstetrics and gynecology [parity and menopause], medication-use [betablocker, diuretic, corticoid, bronchodilator] and smoking. Parity was introduced in two forms: numerical (unit) and groups [small: 10 was considered abnormal [21]. Smoking data: cigarette-smoking [pack-years (PY)] and narghile-use [narghile-years (NY)] were evaluated. Two groups of smokers were identified [14,17] [Non-smoker (
