Pulmonary artery obstruction index and RV/LV ratio in patients with pulmonary embolism as a severity index risk factor for obstructive sleep apnea

Abstract

Introduction: A growing evidences that obstructive sleep apnea (OSA) is a risk for pulmonary embolism (PE). The aim was to investigate computed tomography obstruction index (CTOI) and the right ventricular (RV) to left ventricular (LV) diameter ratio with OSA severity. Patients and Methods: Of 46 patients, Pulmonary artery obstruction index (PAOI) and RV/LV diameter ratio was measured by pulmonary angiography. Pulmonary Embolism Severity Index (PESI) was determined. Epworth Sleepiness Scale (ESS) and polysomnography (PSG) was performed for all patients. Based on the PAOI, patients divided into 3 groups ( 50%). Results: No differences were found in age, neck and waist circumference. Patients with a higher PAOI had a significant increase in BMI; more often provoked PE, a higher rate of thrombolysis, a longer duration of hospitalization, higher rate of recurrent VTE, and a higher RV/LV ratio. 55.6%, 38.9% with a higher PAOI presented with snoring and daytime sleepiness. Regarding PSG, AHI were significantly increased with increase the PAOI. Also, desaturation index and T 90 were significantly increased. There was a correlation between mean percentage of PAOI and AHI (r= 0.957, P = 0.000). Also, a positive correlation was observed between RV/LV diameter ratio and AHI (r= 0.825, P= 0.000). In regression analysis, PAOI >40%, RV/ LV >1 were predictors of OSA. Conclusion: Patients with greater pulmonary artery obstruction had more sever sleep apnea. PAOI >40%, RV/ LV >1 were predictors of sleep apnea among patients with acute PE.