Usefulness of Low Cardiac Index to Predict Sleep-Disordered Breathing in Chronic Thromboembolic Pulmonary Hypertension

The American Journal of Cardiology
Jeremy E OrrRobert L Owens

Abstract

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/m(2); 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 cir...Continue Reading

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Citations

Nov 1, 2016·Respirology : Official Journal of the Asian Pacific Society of Respirology·Jeremy E OrrScott A Sands
Aug 9, 2017·Current Opinion in Pulmonary Medicine·Hang S WongYingJuan Mok
Feb 25, 2020·Circulation·Stephan RosenkranzMarius M Hoeper
Apr 9, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Bilal SamhouriNeal F Chaisson
Oct 30, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Bilal F SamhouriNeal F Chaisson
Mar 16, 2021·American Journal of Respiratory and Critical Care Medicine·Jeremy E OrrM Safwan Badr

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