[Sleep disorders dynamics in patients with chronic thromboembolic pulmonary hypertension after surgical treatment].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2026-03-17 DOI:10.26442/00403660.2026.03.203621

A V Ershov, O O Mikhailova, E M Elfimova, K V Mershin, O V Rodnenkov, N M Danilov, A Y Litvin, I E Chazova

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引用次数: 0

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.

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慢性血栓栓塞性肺动脉高压手术治疗后的睡眠障碍动态

目的：探讨慢性血栓栓塞性肺动脉高压（CTEPH）患者手术前后各种睡眠障碍与临床状态变化的关系。材料和方法：该研究纳入了43例确诊为CTEPH的患者，住院时间为2023年12月至2025年2月。评估包括一般临床状况、超声心动图和右心导管检查资料。患者完成标准化问卷调查（STOP-Bang、Epworth嗜睡量表、匹兹堡睡眠质量指数、失眠严重程度指数、国际不宁腿综合征研究组评定量表），并在治疗前和完成一系列球囊肺血管成形术或肺血栓动脉内膜切除术后至少3个月接受多功能睡眠监测。结果：手术治疗后，CTEPH患者的平均肺动脉压- mPAP （p < 0.0001）和肺血管阻力- PVR （p < 0.0001）显著降低，但睡眠呼吸暂停/低通气（83.8%）和夜间低氧血症（74.4%）的发生率仍然很高。饱和度低于90%的总睡眠时间基线百分比（T90）与术后mPAP （p = 0.0289）、PVR （p = 0.0050）和6分钟步行测试距离- 6MWD （p = 0.0305）显著相关。术前T90 bb0 11.0%预测治疗后达到6MWD目标的敏感性为85.7% （p = 0.0130）。结论：尽管对基础疾病进行了有效的病理治疗，但CTEPH患者中睡眠呼吸障碍的高发率仍然存在。夜间低氧血症可能被认为是处方及时呼吸支持和肺动脉高压特异性治疗的预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.