Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study

Karamanzanis, George; Panou, Fotios; Lazaros, George; Oikonomou, Evangelos; Nikolopoulos, Ioannis; Mihaelidou, Makrina; Ntounis, George; Lekakis, John

doi:10.1007/s11325-014-1026-5

Cited by 16 publications

(13 citation statements)

References 38 publications

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“…Although the trans-tricuspid gradient did not show improvement at follow up, it was slightly reduced when compared to baseline values in the CPAP group. There are several studies which confirm these findings [55][56][57].Karamanzanis et colleagues [58] showed partially similar results, the differences between the findings consisting of the effect of CPAP on RV diameter and LVEF, parameters which did not improve through our follow up period. In an observational study [59], the group showed that 6 months of CPAP therapy improved pulmonary hypertension in OSA patients, these results being in accordance with other studies [60].…”

Section: Effect On Ventricular Functionsupporting

confidence: 75%

A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients

Chetan

Maierean

Gergely

et al. 2021

JPM

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Background: Despite efforts at treatment, obstructive sleep apnea (OSA) remains a major health problem, especially with increasing evidence showing an association with cardiovascular morbidity and mortality. The treatment of choice for OSA patients is Continuous Positive Airway Pressure (CPAP), which has been proven in randomized controlled trials to be an effective therapy for this condition. The impact of CPAP on the cardiovascular pathology associated with OSA remains, however, unclear. Although the effect of CPAP has been previously studied in relation to cardiovascular outcome, follow-up of the treatment impact on cardiovascular risk factors at one year of therapy is lacking in a Romanian population. Thus, we aimed to evaluate the one-year effect of CPAP therapy on lipid profile, inflammatory state, blood pressure and cardiac function, assessed by echocardiography, on a cohort of Romanian OSA patients. Methods: We enrolled 163 participants and recorded their baseline demographic and clinical characteristics with a follow-up after 12 months. Inflammatory and cardiovascular risk factors were assessed at baseline and follow up. Results: Our results show that CPAP therapy leads to attenuation of cardiovascular risk factors including echocardiographic parameters, while having no effect on inflammatory markers. Conclusion: Treatment of OSA with CPAP proved to have beneficial effects on some of the cardiovascular risk factors while others remained unchanged, raising new questions for research into the treatment and management of OSA patients.

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Section: Effect On Ventricular Functionsupporting

confidence: 75%

A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients

Chetan

Maierean

Gergely

et al. 2021

JPM

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“…Similar findings on the right ventricular size and function were obtained in a very recent uncontrolled study among 44 patients with moderate or severe OSA following 12 months of CPAP. 82 …”

Section: The Cardiovascular System In Osamentioning

confidence: 99%

A clinical approach to obstructive sleep apnea as a risk factor for cardiovascular disease

Maeder¹,

Schoch²,

Rickli³

2016

VHRM

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Obstructive sleep apnea (OSA) is associated with cardiovascular risk factors, cardiovascular diseases, and increased mortality. Epidemiological studies have established these associations, and there are now numerous experimental and clinical studies which have provided information on the possible underlying mechanisms. Mechanistic proof-of-concept studies with surrogate endpoints have been performed to demonstrate that treatment of OSA by continuous positive airway pressure (CPAP) has the potential to reverse or at least to attenuate not only OSA but also the adverse cardiovascular effects associated with OSA. However, no randomized studies have been performed to demonstrate that treatment of OSA by CPAP improves clinical outcomes in patients with cardiovascular risk factors and/or established cardiovascular disease and concomitant OSA. In the present review, we summarize the current knowledge on the role of OSA as a potential cardiovascular risk factor, the impact of OSA on cardiac function, the role of OSA as a modifier of the course of cardiovascular diseases such as coronary artery disease, atrial fibrillation, and heart failure, and the insights from studies evaluating the impact of CPAP therapy on the cardiovascular features associated with OSA.

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confidence: 93%

“…We appreciate the interest of A.M. Esquinas and R. PerezRojo regarding our manuscript [1] relevant to the impact of continuous positive airway pressure (CPAP) treatment on myocardial performance, in patients with obstructive sleep apnea (OSA).…”

mentioning

confidence: 99%

Reply: Long term impact of CPAP on myocardial function in OSA. Always measurable cardiac index?

Lazaros¹,

Karamanzanis²,

Panou

et al. 2014

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We appreciate the interest of A.M. Esquinas and R. PerezRojo regarding our manuscript [1] relevant to the impact of continuous positive airway pressure (CPAP) treatment on myocardial performance, in patients with obstructive sleep apnea (OSA).We agree that beyond OSA, various factors and associated comorbidities may affect left-and right-sided myocardial performance [2]. Nevertheless, in our study, we selected a cohort of patients with a little comorbidity as possible in order to focus on the net effect of CPAP treatment on OSA patients and to exclude possible confounders. We would also like to emphasize that our study was designed to give clues on how CPAP treatment affects cardiac function in patients with either moderate or severe OSA, since according to the guidelines, the latter subgroup of patients is eligible for CPAP treatment [3]. Moreover, we applied a regression model for the association between the change in apnea-hypopnea index and the change in the estimated pulmonary artery systolic pressure. Therefore, we can indirectly draw conclusions on the impact of OSA severity and weight, body mass index, and neck circumference on the outcome of CPAP treatment.Furthermore, we agree that a study specifically designed to examine the relative impact of short-versus longer-term application of CPAP would be of interest, since in our study, there was no improvement of pulmonary artery systolic pressure according to the percentage of days on CPAP use. Finally, we would like to assert that the dropout of 13 patients from the study did not affect our final results since we applied a paired analysis in which values before CPAP and after completion of the study period were compared for every patient as a match. The same analysis also ensured that the impact of medications was not a significant determinant of the outcome, since there were no changes of treatment during the study period.In conclusion, as OSA is associated with numerous comorbidities and the patients' compliance is not assured, it is difficult to predict response to treatment in such a population [4]. Nevertheless, as awareness of the clinical significance of OSA steadily increases, specifically designed studies are required to address in detail the net impact of CPAP treatment on myocardial performance.

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Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study

Abstract: CPAP therapy in OSA patients was found to improve right heart chambers remodeling and performance as well as somatometric characteristics. The impact of CPAP on LV performance seems less pronounced.

Cited by 16 publications

References 38 publications

A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients

A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients

A clinical approach to obstructive sleep apnea as a risk factor for cardiovascular disease

Reply: Long term impact of CPAP on myocardial function in OSA. Always measurable cardiac index?

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