Ter Arkh. 2026 Mar 17;98(3):176-182. doi: 10.26442/00403660.2026.03.203621.
ABSTRACT
AIM: To investigate the association between various sleep disorders and changes in clinical status in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after surgical treatment.
MATERIALS AND METHODS: The study included 43 patients with a verified diagnosis of CTEPH hospitalized between December 2023 and February 2025. Assessment included general clinical status, echocardiography, and right heart catheterization data. Patients completed standardized questionnaires (STOP-Bang, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, International Restless Legs Syndrome Study Group Rating Scale) and underwent polyfunctional sleep monitoring before treatment and at least 3 months after completing a series of balloon pulmonary angioplasties or pulmonary thromboendarterectomy.
RESULTS: After surgical treatment, patients with CTEPH maintained a high prevalence of sleep apnea/hypopnea (83.8%) and nocturnal hypoxemia (74.4%), despite a significant decrease in mean pulmonary artery pressure - mPAP (p < 0.0001) and pulmonary vascular resistance - PVR (p < 0.0001). The baseline percentage of total sleep time with saturation below 90% (T90) was significantly associated with postoperative mPAP (p = 0.0289), PVR (p = 0.0050), and the six-minute walk test distance - 6MWD (p = 0.0305). A preoperative T90 > 11.0% showed 85.7% sensitivity in predicting the achievement of the target 6MWD (p = 0.0130) after treatment.
CONCLUSION: A high prevalence of sleep-disordered breathing in patients with CTEPH persists despite effective pathogenetic treatment of the underlying disease. Nocturnal hypoxemia may be considered a predictor for prescribing timely respiratory support and pulmonary arterial hypertension-specific therapy.
PMID:41859794 | DOI:10.26442/00403660.2026.03.203621