TY - JOUR
T1 - Balloon pulmonary angioplasty attenuates sleep apnea in patients with chronic thromboembolic pulmonary hypertension
AU - Kono, Takashi
AU - Fukuoka, Ryoma
AU - Kawakami, Takashi
AU - Kataoka, Masaharu
AU - Kimura, Mai
AU - Sano, Motoaki
AU - Fukuda, Keiichi
N1 - Funding Information:
None. This research was not funded by any special grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that there are no conflicts of interest including related consultancies, shareholdings, and funding grants. This study was approved by the Keio University School of Medicine Ethics Committee. Informed consent was obtained from patients.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/7/1
Y1 - 2019/7/1
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.
AB - 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.
KW - Balloon pulmonary angioplasty
KW - Chronic thromboembolic pulmonary hypertension
KW - Sleep apnea
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U2 - 10.1016/j.hrtlng.2019.04.001
DO - 10.1016/j.hrtlng.2019.04.001
M3 - Article
C2 - 31029378
AN - SCOPUS:85064665539
SN - 0147-9563
VL - 48
SP - 321
EP - 324
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
IS - 4
ER -