Continuous positive airway pressure in heart failure patients with obstructive sleep apnoea

Authors: Ferrier¹; Neill; O'Meeghan¹; Richards²; Campbell³

Source: Internal Medicine Journal, Volume 38, Number 11, November 2008 , pp. 829-836(8)

Publisher: Wiley-Blackwell

Abstract:

Background: 

The aim of the study was to study the effect of 6 months of continuous positive airway pressure (CPAP) in community heart failure (HF) patients with obstructive sleep apnoea (OSA). Methods: 

Clinically stable outpatients with HF and OSA (left ventricular ejection fraction (LVEF) <45%, apnoea/hypopnoea index >15/h, n = 19) treated with CPAP and a control group (LVEF <45%, apnoea/hypopnoea index <10/h, n = 7) were compared at baseline and at 6 months by Minnesota heart failure score, Epworth sleepiness score, shuttle walk distance, brain natriuretic peptide, urinary catecholamines and echocardiographic indices using paired t-test, McNemar's tests and effect sizes. Results: 

In HF patients with OSA, CPAP improved LVEF (35.9 ± 6.1% to 40.6 ± 8.0%, P = 0.015), decreased LV end-systolic volume (152 ± 74 to 135 ± 62 cm³, P = 0.03), systolic blood pressure (P = 0.04) and sleepiness (Epworth sleepiness score 8.8 ± 4.8 to 6.3 ± 3.2, P = 0.01), whereas walk distance, catecholamines, brain natriuretic peptide levels and symptoms were unchanged. These outcomes did not change in the HF control group. Conclusion: 

In community HF patients with OSA, CPAP therapy over 6 months improved LVEF, systolic blood pressure and sleepiness, but not sympathetic activation, brain natriuretic peptide or exercise levels. Acceptance was relatively low, potentially limiting therapeutic effectiveness.

Keywords: congestive heart failure; echocardiography; continuous positive airway pressure; obstructive sleep apnoea

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1445-5994.2007.01585.x

Affiliations: 1: Department of Cardiology, Hutt Valley District Health Board 2: Cardioendocrine Research Centre, Christchurch School of Medicine and Health Sciences, Christchruch, New Zealand 3: Department of Medicine, WellSleep, University of Otago, Wellington

Publication date: 2008-11-01

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