Document Detail


Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men.
MedLine Citation:
PMID:  16009798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine the role of obstructive sleep apnea syndrome (OSAS) as an independent risk factor for the development of left ventricular diastolic abnormalities. Moreover, we tested the hypothesis that nasal continuous positive airway pressure (nCPAP) improves such alterations in OSAS patients by eliminating apneic events. METHODS AND RESULTS: In this prospective, randomized, placebo-controlled, double-blind crossover study, 27 consecutive newly diagnosed middle-aged OSAS men with neither controllable factors nor conditions affecting left ventricular diastolic function and 15 healthy control subjects were selected. OSAS patients were randomized to 12 weeks on sham nCPAP and 12 weeks on effective nCPAP application. Echocardiographic parameters, blood pressure recordings, and urinary catecholamine levels were obtained at baseline and after both treatment modalities. At baseline, an abnormal left ventricular filling pattern was present in 15 of the 27 OSAS patients and only in 3 of the 15 control subjects (P=0.020). Impaired relaxation was by far the most common abnormal pattern in both groups (11 and 3 patients, respectively). In OSAS patients, 12 weeks on effective nCPAP induced a significant increase in E/A ratio (P<0.01), as well as reductions in mitral deceleration (P<0.01) and isovolumic relaxation (P<0.05) times. CONCLUSIONS: OSAS can affect left ventricular diastolic function independently of other possible factors. Chronic application of nCPAP could avoid the progression of diastolic abnormalities, and indeed, it might reverse these alterations, at least in the initial stages before severe structural changes can be developed.
Authors:
Miguel A Arias; Francisco García-Río; Alberto Alonso-Fernández; Olga Mediano; Isabel Martínez; José Villamor
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-07-11
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-19     Completed Date:  2006-02-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-83     Citation Subset:  AIM; IM    
Affiliation:
Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Continuous Positive Airway Pressure*
Cross-Over Studies
Diastole*
Double-Blind Method
Echocardiography
Humans
Male
Middle Aged
Prospective Studies
Sleep Apnea, Obstructive / physiopathology*,  therapy*
Ventricular Dysfunction, Left / therapy
Ventricular Function, Left*
Comments/Corrections
Comment In:
Circulation. 2006 Jan 3;113(1):e11; author reply e11   [PMID:  16391160 ]

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