Prevalence of elevated right ventricular pressure in children with obstructive sleep apnea syndrome undergoing pulmonary hypertension screening.

Study objectives Our objective was to determine the prevalence of elevated right ventricular pressure (RVP) as a surrogate marker for pulmonary hypertension (PH) in children with obstructive sleep apnea syndrome (OSAS) undergoing echocardiography. Methods Retrospective chart review of children age 2-21 years diagnosed with OSAS by an overnight polysomnogram (PSG) who underwent cardiac echocardiogram to screen for PH within 6 months of PSG in a tertiary inner-city pediatric hospital. The primary outcome was elevated RVP defined by estimated RVP ≥ 25 mm Hg above right atrial pressure or ventricular septal configuration consistent with elevated RVP. Results A total of 174 children were included. The median (interquartile range [IQR]) age was 8.9 (5.5-13.1) years with 59.2% male, 41.4% Hispanic, and 25.9% non-Hispanic Black. The prevalence of obesity was 72.0% and severe or very severe OSAS was present in 93.1%. The median (IQR) apnea-hypopnea index was 28.3 events/h (18.8-52.7 events/h). Seven children (4.0%) had elevated RVP. There was no association between elevated RVP and age, sex, race, BMI percentile, apnea-hypopnea index (AHI), oxygen nadir, or severe (AHI ≥ 10) OSAS. Conclusions Elevated RVP was rare and was not associated with OSAS severity. The prevalence in this cohort is higher than the prevalence of PH noted in similar studies (0-1.8%), which may be related to differences in methodology or unassessed cohort characteristics. Further effort to determine the optimal role for PH screening in pediatric OSAS is needed.