| The impact of positive airway pressure on cardiac status and clinical outcomes in patients with advanced heart failure and sleep-disordered breathing: a preliminary report. | |
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MedLine Citation:
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PMID: 20890666 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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INTRODUCTION: Heart failure (HF) is a major public health problem associated with high rates of morbidity and mortality. Patients with HF exhibit a high prevalence of sleep-disordered breathing (SDB). We have investigated the long-term impact of positive airway pressure (PAP) therapy on heart function and clinical outcomes in patients with advanced HF and concomitant SDB. MATERIALS AND METHODS: We assessed 18 patients with advanced HF (New York Heart Association (NYHA) functional classification III-IV) and concomitant SDB (diagnosed with polysomnography) either of obstructive or central type. Eleven patients who received PAP therapy (auto-titrating PAP or adaptive servo-ventilation) for 12 months were compared with seven patients who refused this therapy. All participants were assessed at both baseline and end of follow-up for NYHA functional status, left and right ventricular function, neurohormonal activation, and exercise tolerance. The rates of hospitalization, deaths, and the combination of both were also recorded. RESULTS: Patients treated with PAP achieved better functional status, higher left ventricular ejection fraction, improved longitudinal right ventricular contractile function, lower levels of b-type natriuretic peptide, and greater exercise performance compared to those who remained untreated. PAP-treated group had a significantly lower incidence of the prespecified combined end-point (i.e., hospital admissions and death) than the control group (87.5 vs. 18.2%, p = 0.013). Interestingly, the mortality rate was 28% (two out of seven patients) in the control group, while no deaths were recorded in the PAP-treated group. DISCUSSION: In this preliminary study, we found that treatment of SDB, irrespective of type, in stable patients with advanced HF receiving optimal medical therapy was associated with improvement in cardiac functional status, ventricular contraction, physical performance, and neurohormonal status, leading to better clinical outcomes. |
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Authors:
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Apostolos Karavidas; Fotis Kapsimalis; George Lazaros; Evaggelos Markozanes; Sophia Arapi; Kiriaki Cholidou; Vassiliki Matzaraki; Konstantina Kyrkou; Dimitris Tsiachris; Evaggelos Matsakas; Vlassios Pyrgakis; Manos Alchanatis |
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Publication Detail:
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Type: Journal Article Date: 2010-10-02 |
Journal Detail:
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Title: Sleep & breathing = Schlaf & Atmung Volume: 15 ISSN: 1522-1709 ISO Abbreviation: Sleep Breath Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9804161 Medline TA: Sleep Breath Country: Germany |
Other Details:
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Languages: eng Pagination: 701-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Athens General Hospital, Achilleos 31, P. Faliron, 115 27, Athens, Greece. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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