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Intensive Care Med. 2002 Sep;28(9):1348-50. Epub 2002 Aug 1.

Acute effects of non-invasive ventilatory support on functional mitral regurgitation in patients with exacerbation of congestive heart failure.

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  • 1Cardiopulmonary Intensive Care Unit, San Sebastiano Hospital, 42015 Correggio-Reggio Emilia, Italy. andreabellone@libero.it

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the acute effects of continuous positive airway pressure (CPAP) and bi-level airway pressure (BiPAP) on functional mitral regurgitation (MR) in patients with acute exacerbation of severe chronic congestive heart failure (CHF).

DESIGN:

A cross-over study.

SETTING:

A cardiopulmonary intensive care unit.

PATIENTS AND INTERVENTIONS:

Ten male patients affected by an acute exacerbation of congestive heart failure and hemodynamically significant MR were submitted to an echocardiograph color Doppler ultrasound evaluation during CPAP and BiPAP non-invasive ventilation. We analyzed left ventricle ejection fraction, area of MR and deceleration time (Dec-t).

OUTCOME MEASURES:

The primary end point was to evaluate whether CPAP and BiPAP were effective in reducing functional MR.

RESULTS:

After 30 min, the area of MR decreased from 10.0+/-2.7 to 8.0+/-2.9 cm(2) with CPAP and from 9.9+/-2.6 to 8.6+/-2.6 cm(2) with BiPAP ( p<0.01); Dec-t increased from 120.9+/-12.7 to 136.0+/-8.7 ms after CPAP and from 120.5+/-11.4 to 134.2+/-13.6 ms after BiPAP ( p<0.01).

CONCLUSION:

In patients with exacerbation of severe CHF and functional MR, both modalities of non-invasive ventilation (CPAP and BiPAP) significantly improved ejection fraction and were equally effective in reducing MR.

[PubMed - indexed for MEDLINE]
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