Auto-titrating continuous positive airway pressure therapy in patients with chronic heart failure and obstructive sleep apnoea: a randomized placebo-controlled trial.

Abstract:

AIMS:Obstructive sleep apnoea (OSA) is highly prevalent in patients with chronic heart failure (CHF) and may contribute to CHF progression. We aimed to determine whether treatment of OSA with continuous positive airway pressure (CPAP) would improve subjective and objective measures of heart failure severity in patients with CHF and OSA. METHODS AND RESULTS:Twenty-six patients with stable symptomatic CHF and OSA were randomized to nocturnal auto-titrating CPAP or sham CPAP for 6 weeks each in crossover design. Study co-primary endpoints were changes in peak VO(2) and 6 min walk distance. Secondary endpoints were changes in left ventricular ejection fraction, VE/VCO(2) slope, plasma neurohormonal markers, and quality-of-life measures. Twenty-three patients completed the study protocol. Mean CPAP and sham CPAP usage were 3.5 +/- 2.5 and 3.3 +/- 2.2 h/night, respectively (P = 0.31). CPAP treatment was associated with improvements in daytime sleepiness (Epworth Sleepiness Score 7 +/- 4 vs. 8 +/- 5, P = 0.04) but not in other quality-of-life measures. There were no changes in other study endpoints. CONCLUSION:In patients with CHF and OSA, auto-titrating CPAP improves daytime sleepiness but not other subjective or objective measures of CHF severity. These data suggest that the potential therapeutic benefits of CPAP in CHF are achieved by alleviation of OSA rather than by improvement in cardiac function.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Smith LA,Vennelle M,Gardner RS,McDonagh TA,Denvir MA,Douglas NJ,Newby DE

doi

10.1093/eurheartj/ehm131

subject

Has Abstract

pub_date

2007-05-01 00:00:00

pages

1221-7

issue

10

eissn

0195-668X

issn

1522-9645

pii

ehm131

journal_volume

28

pub_type

杂志文章,多中心研究,随机对照试验
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    pub_type: 临床试验,杂志文章,随机对照试验

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    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章,评审

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/6.suppl_b.85

    authors: Livni E,Elmaleh DR,Barlai-Kovach MM,Goodman MM,Knapp FF Jr,Strauss HW

    更新日期:1985-08-01 00:00:00

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    pub_type: 杂志文章

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    authors: Schöbel WA,Voelker W,Haase KK,Karsch KR

    更新日期:1999-09-01 00:00:00