Association of Prolonged Nocturnal Hypoxemia with Clinical Worsening in Patients with Chronic Thromboembolic Pulmonary Hypertension Undergoing Pulmonary Endarterectomy

Background: Obstructive sleep apnea (OSA) is common in patients with chronic thromboembolic pulmonary hypertension (CTEPH), but the pathological determinants of adverse outcomes remain unknown. This study aimed to investigate prognostic significance various parameters CTEPH undergoing endarterectomy. Methods: Consecutive diagnosed who underwent overnight cardiorespiratory polygraphy for assessment OSA were enrolled. Time-to-event analysis was performed investigating indices (e.g., apnea-hypopnea index [AHI], time percentage oxygen saturation below <90% [T90]) and clinical worsening using log-rank test, multivariable Cox proportional hazard models adjusted multiple confounders. Results: Of 71 operable polygraphy, 36 (50.7%) had (AHI ≥5) 32 (45.1%) nocturnal hypoxemia (T90 ≥30%). A 10% increase T90 associated a 27% greater risk worse hemodynamics, as quantified by mean artery pressure ≥46 mmHg (odds ratio: 1.27, 95% confidence interval [CI]: 1.07–1.50, p = 0.006). Clinical (CW) experienced 19 (26.8%) over median follow-up 26.8 months. AHI did not predict higher CW (hazard ratio [HR]: 1.00, CI: 0.93–1.06, 0.906). cumulative incidence seen than those normoxemia (43.8% vs. 12.8%, 0.017). regression revealed association between an increased (HR: 3.27, 1.17–9.13, 0.024), these associations persisted after covariate adjustment. Conclusions: Nocturnal predictor short- long-term events among CTEPH.