Balloon pulmonary angioplasty attenuates sleep apnea in patients with chronic thromboembolic pulmonary hypertension.
Aged
Angioplasty, Balloon
/ methods
Cardiac Catheterization
Chronic Disease
Female
Humans
Hypertension, Pulmonary
/ complications
Male
Middle Aged
Polysomnography
Pulmonary Artery
/ surgery
Pulmonary Embolism
/ complications
Pulmonary Wedge Pressure
/ physiology
Retrospective Studies
Sleep Apnea Syndromes
/ etiology
Tomography, X-Ray Computed
Balloon pulmonary angioplasty
Chronic thromboembolic pulmonary hypertension
Sleep apnea
Journal
Heart & lung : the journal of critical care
ISSN: 1527-3288
Titre abrégé: Heart Lung
Pays: United States
ID NLM: 0330057
Informations de publication
Date de publication:
Historique:
received:
22
10
2018
revised:
02
04
2019
accepted:
02
04
2019
pubmed:
29
4
2019
medline:
10
3
2020
entrez:
29
4
2019
Statut:
ppublish
Résumé
Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in chronic thromboembolic pulmonary hypertension (CTEPH) patients. However, whether it affects the severity of sleep apnea (SA) remains unknown. We investigated the effect of BPA on the severity of SA in CTEPH patients. We studied 13 patients with CTEPH who had an apnea hypopnea index (AHI) > 10 before BPA and underwent a second polygraph test 6 months after the last BPA session. BPA decreased pulmonary vascular resistance, mean pulmonary artery pressure (PAP), and plasma B-type natriuretic peptide levels, and increased the 6-minute walking distance. BPA decreased the AHI (from 20.9 [13.9-35.7] to 16.3 [7.7-21.8] times/hour, P = 0.023) and hypopnea index (from 13.2 [8.4-22.5] to 6.4 [3.8-10.9] times/hour, P = 0.013), but not the obstructive, central, or mixed apnea index. The change in AHI correlated with that in mean PAP, but not with the change in body mass index or other parameters of hemodynamics. BPA-induced improvement in hemodynamics was associated with the attenuation of SA in patients with CTEPH and SA. Therefore, close attention should be paid to SA in CTEPH patients, and SA should be re-evaluated after BPA to avoid overestimating its severity.
Sections du résumé
BACKGROUND
Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in chronic thromboembolic pulmonary hypertension (CTEPH) patients. However, whether it affects the severity of sleep apnea (SA) remains unknown. We investigated the effect of BPA on the severity of SA in CTEPH patients.
METHODS
We studied 13 patients with CTEPH who had an apnea hypopnea index (AHI) > 10 before BPA and underwent a second polygraph test 6 months after the last BPA session.
RESULTS
BPA decreased pulmonary vascular resistance, mean pulmonary artery pressure (PAP), and plasma B-type natriuretic peptide levels, and increased the 6-minute walking distance. BPA decreased the AHI (from 20.9 [13.9-35.7] to 16.3 [7.7-21.8] times/hour, P = 0.023) and hypopnea index (from 13.2 [8.4-22.5] to 6.4 [3.8-10.9] times/hour, P = 0.013), but not the obstructive, central, or mixed apnea index. The change in AHI correlated with that in mean PAP, but not with the change in body mass index or other parameters of hemodynamics.
CONCLUSIONS
BPA-induced improvement in hemodynamics was associated with the attenuation of SA in patients with CTEPH and SA. Therefore, close attention should be paid to SA in CTEPH patients, and SA should be re-evaluated after BPA to avoid overestimating its severity.
Identifiants
pubmed: 31029378
pii: S0147-9563(18)30521-1
doi: 10.1016/j.hrtlng.2019.04.001
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
321-324Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.