TABLE VII.B.1.
Association between OSA and pulmonary hypertension
| Study | Year | LOE | Study design | Study groups | Clinical endpoint | Conclusion |
|---|---|---|---|---|---|---|
| Minic et al.775 | 2014 | 2b | Retrospective cross-sectional | Patients with group 1 PAH (n = 52) | Prevalence and clinical predictors of SDB and impact on outcomes | SDB present in 71% of PAH patients; 60% had significant hypoxemia (>10% of total sleep time at <90% oxyhemoglobin saturation). |
| Minai et al.774 | 2009 | 2b | Prospective cohort | OSA patients undergoing right heart catheterization for suspected PH | 1) Predictors of PAH in OSA patients 2) Survival in patients with OSA and PAH |
Female gender, younger age, obesity, and nocturnal desaturation were associated with development of PH and OSA patients. PH increases mortality in patients with OSA. |
| Imran et al.772 | 2016 | 2a | Systematic review | Patients with PH and OSA on CPAP (n = 222) | Mean pulmonary artery pressure | CPAP therapy is associated with a significantly lower PA pressure in patients with isolated OSA and PH (13.3 mmHg; 95% CI 12.7–14.0). |
| Sun et al.777 | 2016 | 2a | Systematic review | Patients with OSA on CPAP (n = 181) | Mean pulmonary artery pressure | CPAP therapy was associated with a statistically significant reduction in pulmonary artery pressure in patients with OSA |
| Arias et al.771 | 2006 | 2b | RCT (cross over) | 1) Severe OSA (n = 23) 2) Healthy controls (n = 10) |
Pulmonary artery systolic pressure | CPAP therapy was associated with a decrease in PASP in patients with PAH and OSA (28.9 + 8.6 to 24.0+5.8 mmHg; p < 0.0001). |
| Sharma et al.747 | 2019 | 2b | RCT | 1) Patients with OSA and heart failure (n = 11) 2) Patients with OSA and heart failure on CPAP (n = 10) |
Pulmonary artery systolic pressure | CPAP therapy was associated with a decrease in PASP in patients with PAH and OSA (58.6 ± 2.5 to 42.8 ± 2.7 mmHg; p = 0.025). |
Abbreviations: AHI, apnea hypopnea index; CPAP, continuous positive airway pressure; OSA, obstructive sleep apnea; PA, pulmonary artery; PAH, pulmonary arterial hypertension; PASP, pulmonary artery systolic pressure; PH, pulmonary hypertension; PSG, polysomnography; RCT, randomized controlled trial; RHC, right heart catheterization; SDB, sleep disordered breathing.