PMID- 20890666
OWN - NLM
STAT- MEDLINE
DCOM- 20120404
LR  - 20211020
IS  - 1522-1709 (Electronic)
IS  - 1520-9512 (Linking)
VI  - 15
IP  - 4
DP  - 2011 Dec
TI  - 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.
PG  - 701-9
LID - 10.1007/s11325-010-0425-5 [doi]
AB  - 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.
FAU - Karavidas, Apostolos
AU  - Karavidas A
AD  - Department of Cardiology, Athens General Hospital, Athens, Greece.
FAU - Kapsimalis, Fotis
AU  - Kapsimalis F
FAU - Lazaros, George
AU  - Lazaros G
FAU - Markozanes, Evaggelos
AU  - Markozanes E
FAU - Arapi, Sophia
AU  - Arapi S
FAU - Cholidou, Kiriaki
AU  - Cholidou K
FAU - Matzaraki, Vassiliki
AU  - Matzaraki V
FAU - Kyrkou, Konstantina
AU  - Kyrkou K
FAU - Tsiachris, Dimitris
AU  - Tsiachris D
FAU - Matsakas, Evaggelos
AU  - Matsakas E
FAU - Pyrgakis, Vlassios
AU  - Pyrgakis V
FAU - Alchanatis, Manos
AU  - Alchanatis M
LA  - eng
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20101002
PL  - Germany
TA  - Sleep Breath
JT  - Sleep & breathing = Schlaf & Atmung
JID - 9804161
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Comorbidity
MH  - Continuous Positive Airway Pressure/*instrumentation
MH  - Equipment Design
MH  - Exercise Tolerance/physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/classification/diagnosis/physiopathology/*therapy
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Natriuretic Peptide, Brain/blood
MH  - Prospective Studies
MH  - Sleep Apnea, Central/diagnosis/physiopathology/*therapy
MH  - Sleep Apnea, Obstructive/diagnosis/physiopathology/*therapy
MH  - Stroke Volume/physiology
MH  - Ventricular Function, Left/physiology
MH  - Ventricular Function, Right/physiology
EDAT- 2010/10/05 06:00
MHDA- 2012/04/05 06:00
CRDT- 2010/10/05 06:00
PHST- 2010/07/04 00:00 [received]
PHST- 2010/09/22 00:00 [accepted]
PHST- 2010/09/03 00:00 [revised]
PHST- 2010/10/05 06:00 [entrez]
PHST- 2010/10/05 06:00 [pubmed]
PHST- 2012/04/05 06:00 [medline]
AID - 10.1007/s11325-010-0425-5 [doi]
PST - ppublish
SO  - Sleep Breath. 2011 Dec;15(4):701-9. doi: 10.1007/s11325-010-0425-5. Epub 2010 Oct 
      2.