The effects of continuous positive airway pressure on plasma brain natriuretic peptide concentrations in patients presenting with acute cardiogenic pulmonary edema with preserved left ventricular systolic function

Bellone, Andrea; Etteri, Massimiliano; Vettorello, Marco; Berruti, Vittorio; Maino, Carlo; Mariani, Massimo A.; Clerici, D; Nessi, Italo; Gini, Giancarlo; Natalizi, Anna; Brunati, Pietro

doi:10.1016/j.ajem.2008.11.002

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…In addition, SDB causes excessive negative intrathoracic pressure and pulmonary‐artery vasoconstriction, resulting in right‐heart volume and pressure overload . Therapy with CPAP rapidly improves pulmonary congestion and decreases wall stress in decompensated HFpEF patients . In addition, CPAP therapy for 2 weeks improves pulmonary function and physical activity in CHF patients, regardless of presence of SDB .…”

Section: Discussionmentioning

confidence: 93%

“…9 Therapy with CPAP rapidly improves pulmonary congestion and decreases wall stress in decompensated HFpEF patients. 34 In addition, CPAP therapy for 2 weeks improves pulmonary function and physical activity in CHF patients, regardless of presence of SDB. 35 Furthermore, CPAP therapy for SDB decreases right atrial and LA volume, 36 RV diameter, 36 pulmonary hypertension, 36 and LV hypertrophy 36 and improves hypertension 37 and cardiac systolic 15,38 and diastolic 38 function in OSA patients.…”

Section: Impacts Of Positive Airway Pressure On Cardiac and Pulmonarymentioning

confidence: 98%

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Beneficial Effects of Positive Airway Pressure Therapy for Sleep‐Disordered Breathing in Heart Failure Patients With Preserved Left Ventricular Ejection Fraction

Yoshihisa

Suzuki

Yokota

et al. 2015

Clinical Cardiology

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Background: Right-heart dysfunction is associated with poor prognosis in heart failure with preserved left ventricular ejection fraction (HFpEF). It remains unclear whether sleep-disordered breathing (SDB) treatment using positive airway pressure (PAP) improves right-heart and pulmonary function and exercise capacity and reduces mortality rates of HFpEF patients. Hypothesis: PAP may improve right-heart and pulmonary function, exercise capacity and prognosis in HFpEF patients with SDB. Methods: One hundred nine consecutive patients with HFpEF (left ventricular ejection fraction >50%) and moderate to severe SDB (apnea-hypopnea index ≥15/h) treated with medications were divided into 2 groups: 31 patients with PAP (PAP group) and 78 patients without PAP (non-PAP group). Right ventricular fractional area change (RV-FAC), tricuspid valve regurgitation pressure gradient (TR-PG), tricuspid valve E/E , forced expiratory volume in 1 second/forced vital capacity (FEV 1 /FVC), percentage of vital capacity, and peak VO 2 were determined before and 6 months later, and all-cause mortality was followed up for 916 days. Results: All parameters improved in the PAP group (RV-FAC, 36.0% -46.5%; TR-PG, 31.1 mm Hg-22.4 mm Hg; tricuspid valve E/E , 7.8-5.1; FEV 1 /FVC, 83.9%-89.8%; percentage of vital capacity, 83.5%-89.9%; and peak VO 2 , 16.6 mL/kg/min-19.6 mL/kg/min; P <0.05, respectively) but not in the non-PAP group. Importantly, all-cause mortality was significantly lower in the PAP group than in the non-PAP group (0% vs 12.8%; log-rank P = 0.014). Conclusions: Positive airway pressure improves right-heart and pulmonary function and exercise capacity and may reduce all-cause mortality in patients with HFpEF and SDB.

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Section: Discussionmentioning

confidence: 93%

Section: Impacts Of Positive Airway Pressure On Cardiac and Pulmonarymentioning

confidence: 98%

Beneficial Effects of Positive Airway Pressure Therapy for Sleep‐Disordered Breathing in Heart Failure Patients With Preserved Left Ventricular Ejection Fraction

Yoshihisa

Suzuki

Yokota

et al. 2015

Clinical Cardiology

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“…У пациентов с ХСН часто наблюдается вторичная митральная регургитация, причиной которой являет ся относительная митральная недостаточность и дис функция папиллярных мышц [51]. Митральная ре гургитация может приводить к увеличению КДО [52]. Исследование A.Bellone et al показало, что НВЛ у па циентов с ХСН III-IV класса по NYHA и ФВ ЛЖ < 35 % может уменьшать митральную регургитацию и, т. о., приводить к уменьшению КДО [52].…”

Section: пациентыunclassified

“…Митральная ре гургитация может приводить к увеличению КДО [52]. Исследование A.Bellone et al показало, что НВЛ у па циентов с ХСН III-IV класса по NYHA и ФВ ЛЖ < 35 % может уменьшать митральную регургитацию и, т. о., приводить к уменьшению КДО [52].…”

Section: пациентыunclassified

Potential for Use of Non Invasive Lung Ventilation in Patients With Decompensated Chronic Heart Failure

Авдеев¹,

Popova²,

Неклюдова³

et al. 2011

Pulʹmonologiâ (Mosk.)

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This open controlled single centre study was designed to evaluate efficacy of non invasive lung ventilation (NIV) in patients with decompensated chronic heart failure (DCHF). Inclusion criteria were inpatient DCHF complicating ischaemic heart disease (IHD) or dilated cardiomyopathy (DCM); the ejection fraction of the left ventricle (EFLV) < 35 %, NYHA functional classes III-IV, age > 40 years, increase in dyspnea during pre vious 7 days. The study involved 33 patients (22 males and 11 females, mean age, 58.94 ± 9.76 years; EFLV, 28.84 ± 5.47 %). The patients were randomized into 2 groups: the 1 st group (n = 22) was treated with the conventional therapy (inhibitors of angiotensin converting enzyme, nitrates, digoxin, diuretics, statins) and NIV (BiPAP or CPAP, 6-8 h / day). The 2 nd group (n = 11) received medications only. The 1 st group patients demonstrated more remarkable improvements in dyspnea, heart beat rate, breathing rate and lung function compared to the 2 nd group patients (p < 0.01). Treatment with HIV increased EFLV, reduced the LV size, decreased blood levels of BNP (p = 0.015), IL 6 (p = 0.015) and CRP (p = 0.006). In the control group, there were no significant changes in central haemodynamics, lung function, BNP concentration or systemic inflammation markers to the 10-14 th days of therapy. NIV was well tolerated; no serious adverse event was recorded during the study. Therefore, NIV could greatly improve dyspnea, central haemodynamics, lung function, and LV dysfunction and reduce systemic inflammation in patients with DCHF.

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“…Continuous positive airway pressure (CPAP) is considered an established treatment for OSA, although contradictory conclusions regarding the effect of CPAP on left ventricular (LV) function in patients with OSA exists; some studies have shown that LV function is improved [4]–[6], and other studies have demonstrated that LV function is unchanged [7]–[8]. Therefore, measurement of the left ventricular ejection fraction (LVEF) is a significant parameter to evaluate LV systolic function, which is a well-established clinical parameter that has essential diagnostic, therapeutic, and prognostic implications, particularly in the setting of heart failure (HF) [9]–[11].…”

Section: Introductionmentioning

confidence: 99%

Impact of Continuous Positive Airway Pressure Treatment on Left Ventricular Ejection Fraction in Patients with Obstructive Sleep Apnea: A Meta-Analysis of Randomized Controlled Trials

Sun

Shi

et al. 2013

PLoS ONE

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BackgroundIt has been known for a long time that obstructive sleep apnea (OSA) is associated with a decreased left ventricular ejection fraction (LVEF). Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA; however, it is unknown whether or not CPAP treatment will improve the LVEF. The aim of the current study was to assess whether or not CPAP treatment improves the LVEF. A meta-analysis was conducted to determine the effect of CPAP treatment on the LVEF among patients with OSA.MethodsA literature search of PubMed, the Web of Science, and Cochrane Collaboration’s database were utilized to identify eligible reports for this trial. Ten randomized controlled trails were examined and the meta-analysis was performed using STATA 11.ResultsA significant improvement in the LVEF was observed after CPAP treatment (weighted mean difference(WMD) = 3.59, 95% CI = 1.74–5.44; P<0.001). Subgroup analysis revealed that patients with OSA and heart failure had a significant improvement in the LVEF after CPAP treatment (WMD = 5.18, 95% CI = 3.27–7.08; P<0.001); however, the LVEF of patients with OSA only increased 1.11% and there was no statistical significance (WMD = 1.11, 95% CI = −1.13–3.35; P = 0.331). Furthermore, based on univariate meta-regression analysis, only the baseline AHI had a statistically significant correlation with the LVEF.ConclusionsOur meta-analysis supports the notion that CPAP may improve the LVEF among patients with OSA.

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The effects of continuous positive airway pressure on plasma brain natriuretic peptide concentrations in patients presenting with acute cardiogenic pulmonary edema with preserved left ventricular systolic function

Cited by 6 publications

References 11 publications

Beneficial Effects of Positive Airway Pressure Therapy for Sleep‐Disordered Breathing in Heart Failure Patients With Preserved Left Ventricular Ejection Fraction

Beneficial Effects of Positive Airway Pressure Therapy for Sleep‐Disordered Breathing in Heart Failure Patients With Preserved Left Ventricular Ejection Fraction

Potential for Use of Non Invasive Lung Ventilation in Patients With Decompensated Chronic Heart Failure

Impact of Continuous Positive Airway Pressure Treatment on Left Ventricular Ejection Fraction in Patients with Obstructive Sleep Apnea: A Meta-Analysis of Randomized Controlled Trials

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