Sleep Apnea Severity Linked to Elevated Pulmonary Capillary Wedge Pressure

Sleep apnea severity was associated with cardiovascular comorbidities and elevated pulmonary capillary wedge pressure (PCWP) in adults, according research presented at the 68th Annual Scientific Sessions and Expo of the American College of Cardiology held March 16 to 19, in New Orleans, Louisiana.

Researchers conducted a retrospective analysis of adult patients (n=820) who had undergone an overnight sleep study between 1999 and 2017 and had also undergone native right heart catheterization up to 1 year before or 3 years after the sleep study.

Catheterization parameters, including mean pulmonary artery pressure, PCWP, pulmonary vascular resistance, and cardiac output, were the primary outcomes.

Sleep apnea was classified as absent, mild, moderate, or severe based on the apnea hypopnea index (AHI) recorded in the sleep study reports. The researchers compared catheterization parameters across the levels of sleep apnea severity. Linear regression was used to assess the link between AHI and hemodynamics, adjusting for age, sex, and body mass index (BMI).

The mean AHI in this cohort of patients was 24.8±27.1 events/h. Patients who had more severe sleep apnea were older, more likely to be men, had higher BMI, and had a higher prevalence of diabetes, hypertension, and atherosclerotic disease vs patients who had less severe sleep apnea.

For each 10-unit increase in AHI, PCWP rose by 0.4 mm Hg (95% CI, 0.2-0.6), adjusting for confounding by age, sex, and BMI.

However, AHI was not associated with a significant change in pulmonary vascular resistance (0.04 Woods units per 10-unit AHI, 95% CI, –0.10 to 0.03) or cardiac output (–0.01 L/min per 10-unit AHI, 95% CI, –0.06 to 0.03).

Based on their finding that sleep apnea severity was associated with elevated PCWP, but not [mean pulmonary artery pressure], the researchers concluded that “[s]leep apnea may not be associated with clinically important persistent daytime pulmonary hypertension.”

Reference

Genuardi M, Ogilvie RP, Handen A, et al. The association of sleep apnea with invasive cardiopulmonary hemodynamics. Presented at: the 68th Annual Scientific Sessions and Expo of the American College of Cardiology; March 16-19, 2019; New Orleans, LA. Abstract 493.

This article originally appeared on Pulmonology Advisor