Document Detail


Impact of continuous positive airway pressure treatment on right ventricle performance in patients with obstructive sleep apnoea, assessed by three-dimensional echocardiography.
MedLine Citation:
PMID:  22437139     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Obstructive sleep apnoea (OSA) is a predictor of right ventricle (RV) impairment. However, there is scant information on the effect of OSA treatment on RV performance. We sought to evaluate the impact of OSA treatment with a continuous positive airway pressure (CPAP) device on RV volume and function, as well as on variables related to pulmonary vascular haemodynamics. METHODS: Fifty-six OSA patients and 50 controls were studied. All individuals underwent three-dimensional echocardiogram (3DE) to estimate RV volumes, function, pulmonary vascular resistance, and tricuspid regurgitation velocity. A total of 30 patients with apnoea-hypopnoea index greater than 20 were randomly selected to receive placebo (n=15) or effective CPAP (n=15) for 24weeks. They underwent 3DE examination on three different occasions: at baseline, after 12weeks, and after 24weeks of CPAP or placebo. RESULTS: Higher pulmonary vascular resistance (2.1 Wood's±0.5 vs. 1.8 Wood's±0.4), larger end-diastolic RV volume index (52.2mL/m(2)±7.3 vs. 49.9mL/m(2)±6.0), larger end-systolic RV volume index (18.7mL/m(2)±4.3 vs. 15.4mL/m(2)±3.6), and lower RV ejection fraction (64.3%±6.8 vs. 68.4%±5.9) were observed in the OSA group compared to non-OSA controls (P<0.05, all). In the effective CPAP group we observed the following changes from the baseline to the 24-week echo evaluation: (A) reduction in pulmonary vascular resistance (2.2 Wood's±0.3 to 1.8 Wood's±0.3); (B) reduction in the RV end-systolic volume index (20.3mL/m(2)±4.5 to 16mL/m(2)±2.1); and (C) increase in RV ejection fraction (63.0%±7.2 to 70.8%±0.9) (P<0.05 for all). CONCLUSION: Twenty-four-week treatment with CPAP improved RV performance but did not change RV structural variables.
Authors:
Wercules Oliveira; Dalva Poyares; Fatima Cintra; Marcelo L C Vieira; Claudio H Fischer; Valdir Moises; Sergio Tufik; Antonio Carvalho; Orlando Campos
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-19
Journal Detail:
Title:  Sleep medicine     Volume:  -     ISSN:  1878-5506     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100898759     Medline TA:  Sleep Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier B.V. All rights reserved.
Affiliation:
Department of Psychobiology, Federal University of Sao Paulo, Sao Paulo, Brazil; Department of Cardiology, Federal University of Sao Paulo, Sao Paulo, Brazil; Albert Einstein Hospital, Sao Paulo, Brazil.
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