Sleep-disordered breathing and lung function abnormalities in adults with congenital heart disease.

PURPOSE: Advances in treatment enables most patients with congenital heart diseases (CHD) to survive into adulthood, implying the need to address comorbid conditions in this growing cohort of patients. The aim of this study was to evaluate the prevalence of sleep-disordered breathing (SDB) and lung function abnormalities in patients with adult congenital heart disease (ACHD). METHODS: Patients with ACHD underwent level 3 sleep testing (Embletta MPR polygraphy) and pulmonary function testing. Results were stratified by the underlying haemodynamic ACHD lesion group. RESULTS: Patients with ACHD (n = 100) were middle-aged (42.3 ± 14.6 years), 54% male and slightly overweight (BMI 25.9 ± 5.5 kg/m2). Polygraphy revealed a prevalence of sleep apnoea of 39% with 15% of patients presenting with predominantly obstructive apnoeic episodes, while 23% of patients presenting primarily with central sleep apnoea. The distribution of mild, moderate, and severe sleep apnoea in the total study population was 26%, 7% and 6%, respectively. Comparison of apnoea-hypopnoea index, presence of sleep apnoea, and apnoea severity did not offer significant differences between the four ACHD lesion groups (p = 0.29, p = 0.41 and p = 0.18, respectively). Pulmonary function testing revealed obstructive lung disease in 19 of 100 patients. Concomitant chronic obstructive pulmonary disease and obstructive sleep apnoea were diagnosed in 3% of patients and were associated with profound nocturnal desaturation. CONCLUSION: The findings suggest a mild propensity amongst patients with ACHD to develop SDB that seems to be unaffected by the specific underlying congenital lesion.

Lung function abnormalities among garri processing workers in Ogbomoso, Nigeria.

BACKGROUND: Local production of garri (cassava crisps) is associated with air pollution and consequently lung function abnormalities among garri processing workers. This study was aimed at describing lung function abnormalities among Nigerians engaged in cassava crisps (garri) processing. METHODS: A total of 351 workers and 351 controls were recruited at garri factories in Ogbomoso, Nigeria by multistage random sampling technique. Lung functional abnormalities were defined according to standardised European Respiratory Society/American Thoracic Society guidelines. Data analysis was performed using the IBM SPSS statistics version 22.0. RESULTS: The mean age of patients was similar to that of controls (41.7 ± 14.9 vs. 41.6 ± 14.7 yearsP = 0.960). Larger proportion (46.2%) of cassava crisps factory workers had abnormal ventilatory function parameters compared to 6.8% in controls (P < 0.001). The mean peak expiratory flow among garri factory workers was significantly lower than that of the controls; 268.25 ± 86.20 versus 349.04 ± 97.21 (L/min) (P < 0.001), likewise the mean forced vital capacity (FVC) (litres) and forced expiratory volume (FEV1) (litres) of garri factory workers and controls were significantly lower than those of the controls; 2.55 ± 1.07 versus 2.87 ± 0.79 (P < 0.001) and 2.00 ± 0.76 versus 2.41 ± 0.83 (P < 0.001) with FEV1/FVC ratio of 0.82 ± 0.16 versus 0.87 ± 0.06 (P < 0.001), respectively. The restrictive pattern of ventilatory functional abnormality was predominant among garri factory workers, 92 (26.2%). Sixty-two (17.7%) and 8 (2.3%) of garri factory workers had an obstructive and mixed pattern of ventilatory function abnormalities, respectively. CONCLUSION: Garri processing workers had significant ventilatory function impairment. Preventive strategies should be encouraged to reduce occupational hazards associated with garri processing in Nigeria.

Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease.

Lung function abnormalities occur in children with sickle cell disease (SCD) and may be associated with elevated pulmonary blood volume. To investigate that association, we determined whether blood transfusion in SCD children acutely increased pulmonary capillary blood volume (PCBV) and increased respiratory system resistance (Rrs5). Measurements of Rrs5 and spirometry were made before and after blood transfusion in 18 children, median age 14.2 (6.6-18.5) years. Diffusing capacity for carbon monoxide and nitric oxide were assessed to calculate the PCBV. Post transfusion, the median Rrs5 had increased from 127.4 to 141.3% predicted (p<0.0001) and pulmonary capillary blood volume from 39.7 to 64.1 ml/m2 (p<0.0001); forced expiratory volume in one second (p=0.0056) and vital capacity (p=0.0008) decreased. The increase in Rrs5 correlated with the increase in PCBV (r=0.50, p=0.0493). Increased pulmonary capillary blood volume may at least partially explain the lung function abnormalities in SCD children.