Balloon pulmonary angioplasty attenuates sleep apnea in patients with chronic thromboembolic pulmonary hypertension

Takashi Kohno, Ryoma Fukuoka, Takashi Kawakami, Masaharu Kataoka, Mai Kimura, Motoaki Sano, Keiichi Fukuda

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalHeart and Lung
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Balloon Angioplasty
Sleep Apnea Syndromes
Pulmonary Hypertension
Lung
Apnea
Hemodynamics
Pulmonary Artery
Pressure
Brain Natriuretic Peptide
Vascular Resistance
Walking
Body Mass Index

Keywords

  • Balloon pulmonary angioplasty
  • Chronic thromboembolic pulmonary hypertension
  • Sleep apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Balloon pulmonary angioplasty attenuates sleep apnea in patients with chronic thromboembolic pulmonary hypertension. / Kohno, Takashi; Fukuoka, Ryoma; Kawakami, Takashi; Kataoka, Masaharu; Kimura, Mai; Sano, Motoaki; Fukuda, Keiichi.

In: Heart and Lung, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Kawakami, Takashi

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AU - Kimura, Mai

AU - Sano, Motoaki

AU - Fukuda, Keiichi

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N2 - 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.

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