Research progress on the bidirectional relationship between sleep-related breathing disorders and pulmonary hypertension

doi:10.11958/20251155

Abstract

Abstract:

Sleep-related breathing disorders (SBDs) are a group of disorders characterized by abnormal breathing patterns during sleep, with obstructive sleep apnea (OSA) being the most common type. Pulmonary hypertension (PH) is characterized pathophysiologically by pulmonary vasoconstriction and vascular remodeling, with initial clinical diagnosis typically relying on echocardiography. SBDs and PH have a bidirectional relationship in many aspects, with shared pathophysiological mechanisms such as hypoxia, inflammation and oxidative stress being common. The percentage of sleep time with nocturnal oxygen saturation <0.90 (T90) can assess the risk of pulmonary hemodynamic and right ventricular function deterioration in OSA patients, but this indicator still has limitation in clinical application. Currently, there is limited domestic research on the bidirectional relationship between SBDs and PH in China. This article reviews the bidirectional relationship between SBDs and PH in terms of epidemiology, potential mechanisms, screening and treatment. It also analyzes the relevance of OSA and PH based on current domestic and international clinical studies, providing a theoretical basis for further exploration of these two diseases.

Key words: sleep apnea, obstructive, pulmonary arterial hypertension, sleep-related breathing disorders, intermittent hypoxia, hypoxic burden, global longitudinal strain

CLC Number:

R56，R544.16

Figures/Tables 2

References 47

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血流动力学分类	界定标准	临床分类
毛细血管前PH	mPAP>20 mmHg，且PAWP≤ 15 mmHg、PVR>2 WU	第1组：PAH；第3组：肺部疾病和/或缺氧相关PH；第4组：肺动脉阻塞相关PH（如CTEPH）；第5组：原因未明和/或多因素所致PH
毛细血管后PH	mPAP>20 mmHg且PAWP> 15 mmHg	第2组：左心疾病相关PH；第5组：原因未明和/或多因素所致PH
孤立性毛细血管后PH	PVR≤2 WU
毛细血管后和毛细血管前混合性PH	PVR>2 WU

血流动力学分类	界定标准	临床分类
毛细血管前PH	mPAP>20 mmHg，且PAWP≤ 15 mmHg、PVR>2 WU	第1组：PAH；第3组：肺部疾病和/或缺氧相关PH；第4组：肺动脉阻塞相关PH（如CTEPH）；第5组：原因未明和/或多因素所致PH
毛细血管后PH	mPAP>20 mmHg且PAWP> 15 mmHg	第2组：左心疾病相关PH；第5组：原因未明和/或多因素所致PH
孤立性毛细血管后PH	PVR≤2 WU
毛细血管后和毛细血管前混合性PH	PVR>2 WU