PMID- 33910200 OWN - NLM STAT- MEDLINE DCOM- 20220516 LR - 20221222 IS - 1423-0356 (Electronic) IS - 0025-7931 (Linking) VI - 100 IP - 9 DP - 2021 TI - Sleep-Disordered Breathing and Nocturnal Hypoxemia in Precapillary Pulmonary Hypertension: Prevalence, Pathophysiological Determinants, and Clinical Consequences. PG - 865-876 LID - 10.1159/000515602 [doi] AB - BACKGROUND AND OBJECTIVE: The clinical relevance and interrelation of sleep-disordered breathing and nocturnal hypoxemia in patients with precapillary pulmonary hypertension (PH) is not fully understood. METHODS: Seventy-one patients with PH (age 63 +/- 15 years, 41% male) and 35 matched controls were enrolled. Patients with PH underwent clinical examination with assessment of sleep quality, daytime sleepiness, 6-minute walk distance (6MWD), overnight cardiorespiratory polygraphy, lung function, hypercapnic ventilatory response (HCVR; by rebreathing technique), amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and cardiac MRI (n = 34). RESULTS: Prevalence of obstructive sleep apnea (OSA) was 68% in patients with PH (34% mild, apnea-hypopnea index [AHI] >/=5 to <15/h; 34% moderate to severe, AHI >/=15/h) versus 5% in controls (p < 0.01). Only 1 patient with PH showed predominant central sleep apnea (CSA). Nocturnal hypoxemia (mean oxygen saturation [SpO2] <90%) was present in 48% of patients with PH, independent of the presence of OSA. There were no significant differences in mean nocturnal SpO2, self-reported sleep quality, 6MWD, HCVR, and lung and cardiac function between patients with moderate to severe OSA and those with mild or no OSA (all p > 0.05). Right ventricular (RV) end-diastolic (r = -0.39; p = 0.03) and end-systolic (r = -0.36; p = 0.04) volumes were inversely correlated with mean nocturnal SpO2 but not with measures of OSA severity or daytime clinical variables. CONCLUSION: OSA, but not CSA, is highly prevalent in patients with PH, and OSA severity is not associated with nighttime SpO2, clinical and functional status. Nocturnal hypoxemia is a frequent finding and (in contrast to OSA) relates to structural RV remodeling in PH. CI - (c) 2021 S. Karger AG, Basel. FAU - Spiesshoefer, Jens AU - Spiesshoefer J AD - Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany. AD - Department of Neurology with Institute for Translational Neurology, University Hospital Muenster, Munster, Germany. AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. FAU - Herkenrath, Simon AU - Herkenrath S AD - Bethanien Hospital Solingen, Solingen, Germany. AD - Institute for Pneumology at the University of Cologne, Solingen, Germany. FAU - Harre, Katharina AU - Harre K AD - Department of Neurology with Institute for Translational Neurology, University Hospital Muenster, Munster, Germany. FAU - Kahles, Florian AU - Kahles F AD - Department of Cardiology, Vascular Medicine and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany. FAU - Florian, Anca AU - Florian A AD - Department of Cardiology I, University Hospital Muenster, Munster, Germany. FAU - Yilmaz, Ali AU - Yilmaz A AD - Department of Cardiology I, University Hospital Muenster, Munster, Germany. FAU - Mohr, Michael AU - Mohr M AD - Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, Munster, Germany. FAU - Naughton, Matthew AU - Naughton M AD - Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia. AD - Department of Medicine, Monash University, Melbourne, Victoria, Australia. FAU - Randerath, Winfried AU - Randerath W AD - Bethanien Hospital Solingen, Solingen, Germany. AD - Institute for Pneumology at the University of Cologne, Solingen, Germany. FAU - Emdin, Michele AU - Emdin M AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. AD - Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy. FAU - Passino, Claudio AU - Passino C AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. AD - Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy. FAU - Regmi, Binaya AU - Regmi B AD - Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany. FAU - Dreher, Michael AU - Dreher M AD - Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany. FAU - Boentert, Matthias AU - Boentert M AD - Department of Neurology with Institute for Translational Neurology, University Hospital Muenster, Munster, Germany. AD - Department of Medicine, UKM Marienhospital Steinfurt, Steinfurt, Germany. FAU - Giannoni, Alberto AU - Giannoni A AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. AD - Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy. LA - eng PT - Journal Article DEP - 20210428 PL - Switzerland TA - Respiration JT - Respiration; international review of thoracic diseases JID - 0137356 SB - IM CIN - Respiration. 2021;100(10):1041-1042. PMID: 34515224 CIN - Respiration. 2022;101(4):433-435. PMID: 34923494 MH - Aged MH - Female MH - Humans MH - *Hypertension, Pulmonary/complications MH - Hypoxia/diagnosis/epidemiology/etiology MH - Male MH - Middle Aged MH - Polysomnography MH - Prevalence MH - *Sleep Apnea Syndromes/complications/epidemiology MH - *Sleep Apnea, Obstructive/complications/diagnosis/epidemiology OTO - NOTNLM OT - Hypoxemia OT - Pulmonary hypertension OT - Right heart failure OT - Sleep-disordered breathing EDAT- 2021/04/29 06:00 MHDA- 2022/05/17 06:00 CRDT- 2021/04/28 20:16 PHST- 2020/11/18 00:00 [received] PHST- 2021/02/22 00:00 [accepted] PHST- 2021/04/29 06:00 [pubmed] PHST- 2022/05/17 06:00 [medline] PHST- 2021/04/28 20:16 [entrez] AID - 000515602 [pii] AID - 10.1159/000515602 [doi] PST - ppublish SO - Respiration. 2021;100(9):865-876. doi: 10.1159/000515602. Epub 2021 Apr 28.