PURPOSE: Patients with obstructive sleep apnea (OSA) may develop pulmonary arterial hypertension (PAH) but may also have left heart involvement producing pulmonary venous hypertension (PVH).Our objective is to study hemodynamic and sleep study (PSG) characteristics in patients with pulmonary arterial hypertension (PAH) and pulmonary venous hypertension (PVH).
METHODS: We reviewed a retrospectively collected database of patients who had both PSG and right heart catheterization (RHC) at our institution between the year 2000-2005. PAH is defined as mPAP≥25 mmHg and PAOP <15 mmHg, and PVH is defined as mPAP≥ 25 and PAOP≥ 15. Data regarding hemodynamics and PSG variables were extracted. Student’s t test was used to compare the variables between the two groups. Two-sided p value of < 0.05 was considered significant.
RESULTS: A total of 74 pts with pulmonary hypertension were identified and divided into 2 groups: PAH (N=22) and PVH(N=52). There was no significant differences in age, body mass index (BMI), mean pulmonary arterypressure (mPAP), arousal index (AI), or REM index (REMI). However, AHI significantly higher in PVH group (p=0.0192). Day time resting oximetry was significantly lower in PAH (p=0.0026), while mean nocturnal desaturation did not reach to a significant level (p=0.0776).Mean right atrial pressure was higher in patients with PVH (p=0.0018), but there was no difference in cardiac output.
CONCLUSION: Daytime resting desaturation and to a lesser extent nocturnal desaturation are more exaggerated in PVH than PAH. Higher AHI in PVH can be secondary to multiple factors other than pure OSA.
CLINICAL IMPLICATIONS: The mechanism of worsening daytime resting oximetry or nocturnal desaturation not secondary to severe AHI or OSA with PVH, and development of PAH may result to other factors than oxygen desaturation.
DISCLOSURE: Basma Ricaurte, None.