Pulmonary Vascular Disease |

Prevalence of Obstructive Sleep Apnea in Patients With Pulmonary Arterial Hypertension and Its Impact on Severity, Mortality, and Functional status FREE TO VIEW

Massa Zantah, MD; Julianne Nichols, DO; Vanessa Yap, MD; Raymond Foley, DO; Debapriya Datta, MD
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University of CT Health Center, Farmington, CT

Chest. 2015;148(4_MeetingAbstracts):947A. doi:10.1378/chest.2260592
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SESSION TITLE: Pulmonary Arterial Hypertension Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary hypertension (PH) is reported to occur in 20- 40% of patients with Obstructive Sleep Apnea (OSA) in the absence of other cardiopulmonary disorders. The prevalence of OSA in Pulmonary Arterial Hypertension (PAH) and its impact on the disease has not been studied.The objective of this study was to determine prevalence of obstructive sleep apnea (OSA) in patients with PAH and its effect on functional capacity, severity and mortality.

METHODS: The medical records of patients with PAH, defined as mean pulmonary artery pressure (mPAP) ≥25mm Hg and mean pulmonary arterial wedge pressure (PAWP) ≤ 15mmHg, being treated at the PH Center at our institution, over the last 6 years (2007 to 2013) was reviewed. The following data was obtained -age, gender, mPAP, pulmonary vascular resistance (PVR), presence of OSA, 6MWD, NYHA class; and alive or expired during follow-up. Impact of OSA on outcomes (severity of PAH measured by mPAP, and PVR; functional status as measured by 6MWD and NYHA class and survival, defined as alive or expired during follow-up) was determined by univariate analysis, using independent t-test.p< 0.0.5 was deemed statistically significant.

RESULTS: Of 75 patients, 75% were female; mean age was 64 + 14 years; mean mPAP of 42 + 13 mmHg; mean PVR of 573 + 384 dynes/sec/cm5. Sixty-two percent patients were alive on follow-up. OSA was present in 12% patients. All studied variables in PAH patients with and without OSA are shown below: Parameters:---------------→ PAH with OSA _vs._ PAH without OSA mPAP----------------------------------→ 52 ± 12 vs. 40±13 (mmHg) [p=0.008] PVR ---------------------------------→ 570 ±2 73 vs. 572± 410 (dynes/sec/cm) [p=0.9] 6MWD -----------------------------→ 382±130 vs. 348 ± 120(m) [p=0.5] NYHA class ------------------------------→ 2 versus 2 [p=0.5] Expired ----------------------------------→ 2/9 versus 20/66. [p=0.2]. mPAP was significantly higher in patients with PAH with OSA compared to those without OSA.

CONCLUSIONS: OSA in PAH is not uncommon with a prevalnce of 12%. It is associated with more severe disease but does not appear to affect functional capacity or survival.

CLINICAL IMPLICATIONS: More studies, on a larger number of subjects, are needed to confirm these findings and to determine whether treatment of OSA, in patients with PAH, decreases disease severity/ improves outcome

DISCLOSURE: The following authors have nothing to disclose: Massa Zantah, Julianne Nichols, Vanessa Yap, Raymond Foley, Debapriya Datta

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