Patients with chronic thromboembolic pulmonary hypertension (CTEPH) often have substantial
right ventricular dysfunction. The resulting low cardiac index might predispose to
sleep disordered breathing (SDB) by increasing ventilatory instability. The prevalence
of SDB and potential association with impaired cardiac index was examined in patients
with CTEPH. Patients referred for evaluation for pulmonary thromboendarterectomy surgery
were recruited. Subjects underwent a sleep study, unless already using positive airway
pressure therapy. Hemodynamic data were obtained from contemporaneous right-sided
cardiac catheterization. A total of 49 subjects were included. SDB—defined as ongoing
positive airway pressure use or apnea-hypopnea index (AHI) ≥5/h—was found in 57% of
subjects. SDB was generally mild in severity, with respiratory events mainly consisting
of hypopneas. Cardiac index was found to be significantly lower in subjects with SDB
than those without (2.19 vs 2.55 L/min/m2; p = 0.024), whereas no differences were observed in other characteristics. Additionally,
cardiac index was independently predictive of AHI. In a subgroup of subjects with
an elevated percentage of central events, both cardiac index and lung to finger circulation
time correlated with AHI. In conclusion, SDB is prevalent in patients with CTEPH and
might decrease with treatments that improve cardiac index.
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Article Info
Publication History
Published online: December 31, 2015
Accepted:
December 17,
2015
Received in revised form:
December 17,
2015
Received:
October 21,
2015
Footnotes
Funding Sources: NIH/NHLBI T32 HL098062-05 .
See page 1005 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.