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Implication of prolonged nocturnal hypoxemia and obstructive sleep apnea for pulmonary hemodynamics in patients being evaluated for pulmonary hypertension: a retrospective study

Writer's picture: S-MedS-Med

Our study offers novel insights into the impact of various sleep respiratory metrics on pulmonary hemodynamics and RV performance in patients with OSA. The key finding was that the severity of OSA-related nocturnal hypoxemia—ie, T90—was closely related to increased levels of mPAP, PVR, and RVSWI, which remained significant independent of potential con-founders. Remarkably, nocturnal hypoxemic duration rather than frequency of respiratory events (ie, REI/AHI) might serve contributing roles in the deterioration of pulmonary hemodynamics and RV function in patients with OSA.

he findings in our study were, in part, consistent with those reported in previous literature. Minai et al9 revealed a higher prevalence of PH diagnosed with RHC in patients with OSA. However, this study was limited to only 83 patients, and the majority had post-capillary PH (48%), suggesting the presence of overt cardiac comorbidities and obesity that may impede the pure associations of pulmonary hemodynamics and OSA. The main difference between our studies thereby resides in our relatively larger sample size and a small proportion of post-capillary PH (9.8%). Because RHC is invasive, it is not usual to perform RHC on all patients diagnosed with OSA.

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