Long-term Treatment of Ischemic Dilated Cardiomyopathy with Continuous Positive Airway Pressure.

Yasuma, Fumihiko; Ogihara, Atsushi

doi:10.2169/internalmedicine.40.1121

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…However, treatment of sleep-disordered breathing with either nasal positive airway pressure or nocturnal oxygen supplementation has an impact on patient outcome. Several studies have shown the beneficial effects of such interventions to improve cardiac function, oxygenation, and overall QOL [18][19][20][21][22]38].…”

Section: Discussionmentioning

confidence: 99%

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Sleep symptoms and clinical markers of illness in patients with heart failure

et al. 2005

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The purpose of this study was to survey patients with heart failure (HF) for sleep symptoms using a standardized questionnaire and correlate symptoms with conventional markers of clinical status. A self-report paper questionnaire was offered to patients presenting to a tertiary care HF clinic. Symptoms were grouped according to "risk" categories and correlated with routine clinical information. One hundred six (52.7% of 201 with all data) respondents had a high pretest probability for sleep apnea syndrome. Sixty three (31.3%) reported symptoms suggesting the presence of chronic insomnia; seven (3.5%) and eight (4%) reported symptoms of narcolepsy and restless legs syndrome, respectively. High-risk respondents for sleep apnea had a higher body mass index (p<0.001), were younger (p<0.05), and had a higher ejection fraction (p<0.05). The odds ratio (confidence interval) for paroxysmal nocturnal dyspnea (PND) to a complaint of sleepiness was 1.99 (1.1-3.6) and to a complaint of insomnia was 3.5 (1.8-6.5). In men, complaints of sleepiness in patients with PND were correlated, 4.47 (1.9-10.3), as was a correlation to high pretest probability for sleep apnea, 2.47 (1.1-5.5). There were no correlation of New York Heart Association status classification to high risk for sleep apnea, but a complaint of insomnia tended to occur with worsening functional status (p<0.05). There was only modest correlation of self-reported symptoms as elicited by a questionnaire and risk for sleep disorders with common clinical assessments for HF. Such collection of symptoms might be useful in establishing guidelines for routine sleep testing or as an adjunct to clinical trials.

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Section: Discussionmentioning

confidence: 99%

“…Treatment of sleepdisordered breathing with continuous positive airway pressure (CPAP) has been shown to improve cardiac function in patients with HF [18][19][20][21][22][23][24]. Furthermore, improvement in sleep symptoms correlates with improvements in QOL indices [25].…”

Section: Introductionmentioning

confidence: 99%

Sleep symptoms and clinical markers of illness in patients with heart failure

et al. 2005

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“…In our previous report on an 81-year-old man with dilated cardiomyopathy with CSR/CSA [6], the author initially utilized a low-pressure CPAP of 5 cm H 2 O, increasing the pressure by 3 cm H 2 O after 24 months and by 2 cm H 2 O after 36 months to cope with the decline in cardiac function. This therapy is analogous to adjusting the dosage of ACE inhibitors or β-blockers in CHF [1].…”

Section: Discussionmentioning

confidence: 99%

Cheyne-Stokes Respiration in Congestive Heart Failure: Continuous Positive Airway Pressure of 5–8 cm H<sub>2</sub>O for 1 Year in Five Cases

Yasuma¹

2005

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Five adult patients with congestive heart failure (CHF) due to dilated cardiomyopathy complicated by Cheyne-Stokes respiration/central sleep apnea (CSR/CSA) were treated with continuous positive airway pressure (CPAP) with an initial pressure of 5 cm H₂O. Four patients were followed up for 12 months with CPAP of 5 cm H₂O. The rest, a 93-year-old patient, was followed up for 30 months, and the CPAP was reset at 8 cm H₂O due to worsened cardiac function after 6 months and it was reset at 6 cm H₂O due to dryness of the nose after 23 months. For all the patients with nightly CPAP use for 6.0 ± 1.4 h per day for a year, frequency of CSR/CSA was significantly reduced after 3 and 12 months with CPAP (p < 0.05). Moreover, their symptoms, cardiac function and sleep quality were significantly improved after 3 months (p < 0.05), and were maintained above the pre-CPAP levels after 12 months, except for the oldest patient whose cardiac function tended to deteriorate. The results suggest that CSR/CSA in CHF can be treated with CPAP set at a lower pressure than the conventional method, and that CPAP at 5–8 cm H₂O is often effective in eliminating CSR/CSA, improving sleep quality, and presumably maintaining cardiac function.

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“…In the present case, the CPAP was adjusted to 5-8 cmH2O, according to the method described by Yasuma (9,10), which is lower than the conventional optimal CPAP pressure of 10-12.5 cmH2O for patients with CHF (11). In contrast, Genovese et al demonstrated that, in pigs with pacinginduced CHF, the cardiac output and left ventricular ejection fraction were enhanced with the use of CPAP at a pressure of 5 cmH2O (12).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Management of Deteriorating Mitral Regurgitation and Heart Failure with Continuous Positive Airway Pressure

et al. 2013

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A 75-year-old Japanese woman with acute mitral valve prolapse and regurgitation, that developed one month previously, suffered from intractably progressive congestive heart failure (CHF). However, the emergent surgery was declined, and pharmacological treatment was discontinued due to hypotension and malignant arrhythmia. She was treated with 5-8 cmH2O of continuous positive airway pressure (CPAP) to manage CHF and Cheyne-Stokes respiration during the preoperative period of five weeks, after which plastic surgery of the mitral valve was successfully performed. CPAP can be an effective non-pharmacological treatment for CHF, unloading the left ventricle hydrostatically in order to reduce mitral regurgitation and improve oxygenation.

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Long-term Treatment of Ischemic Dilated Cardiomyopathy with Continuous Positive Airway Pressure.

Cited by 5 publications

References 21 publications

Sleep symptoms and clinical markers of illness in patients with heart failure

Sleep symptoms and clinical markers of illness in patients with heart failure

Cheyne-Stokes Respiration in Congestive Heart Failure: Continuous Positive Airway Pressure of 5–8 cm H<sub>2</sub>O for 1 Year in Five Cases

Preoperative Management of Deteriorating Mitral Regurgitation and Heart Failure with Continuous Positive Airway Pressure

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