title: Sleep-Disordered Breathing in Patients with Pulmonary Valve Incompetence Complicating Congenital Heart Disease.
abstract: OBJECTIVE
  Long standing pulmonary regurgitation results in deleterious effects on right heart size and function with late consequences of right heart volume overload including ventricular dilatation, propensity to arrhythmia and right heart failure. As sleep disordered breathing may predispose to elevations in pulmonary vascular resistance and associated negative effects on right ventricular function, we sought to assess this in patients with underlying congenital heart disease.
  
  
  METHODS
  We performed a pilot study to evaluate the incidence of sleep-disordered breathing in a patient population with a history of long standing pulmonary valve incompetence in patients with congenital heart disease using overnight oximetry.
  
  
  METHODS
  Patients with a background of tetralogy of Fallot repair or residual pulmonary incompetence following previous pulmonary valve intervention for congenital pulmonary stenosis were included.
  
  
  RESULTS
  Twenty-two patients underwent overnight oximetry. The mean age of the cohort was 34.3 ± 15.2 years with no patients observed to have severe underlying pulmonary hypertension. Abnormal overnight oximetry was seen in 13/22 patients (59.1%) with 2/22 (9.1%) patients considered to have severe abnormalities.
  
  
  CONCLUSIONS
  An important proportion of patients with a background of pulmonary incompetence complicating congenital heart disease are prone to the development of sleep-disordered breathing as assessed by overnight oximetry. Further study into the prevalence and mechanisms of sleep-disordered breathing in a larger cohort are warranted.
authors.affiliation: Department of General Medicine, John Hunter Hospital, Newcastle, Australia.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.|Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Miles
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Newcastle, Australia.
authors.forename: Waheed
authors.initials: W
authors.lastname: Ahmad
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Newcastle, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Bailey
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Newcastle, Australia.
authors.forename: Rachael
authors.initials: R
authors.lastname: Hatton
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.|Cardiovascular Department, John Hunter Hospital, Newcastle, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Boyle
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Newcastle, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010092:Oximetry; D010865:Pilot Projects; D011664:Pulmonary Valve / Q000503:physiopathology*; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Congenital Heart Disease; Pulmonary Regurgitation; Sleep Apnea; Tetralogy of Fallot