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Eur Respir J. 2018 Jan 31;51(2). pii: 1701774. doi: 10.1183/13993003.01774-2017. Print 2018 Feb.

Effects of continuous positive airway pressure therapy on left ventricular diastolic function: a randomised, sham-controlled clinical trial.

Author information

1
Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Republic of Korea.
2
Both authors contributed equally.
3
Dept of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
4
Dept of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
5
Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Republic of Korea grhong@yuhs.ac.

Abstract

Continuous positive airway pressure (CPAP) therapy may decrease left ventricular (LV) loads and improve myocardial oxygenation. In this study, we investigated the effect of CPAP on LV diastolic function compared with sham treatment in patients with severe obstructive sleep apnoea (OSA).This 3-month prospective single-centre randomised sham-controlled trial analysed 52 patients with severe OSA. Patients were randomly assigned (1:1) to receive either CPAP or sham treatment for 3 months. The main investigator and patients were masked to the trial randomisation. The primary end-point was change of early diastolic mitral annular (e') velocity over the 3-month period. Secondary end-points were pulse wave velocity (PWV), 24-h ambulatory blood pressure (BP) and variables of ventricular-vascular coupling at 3 months.After 3 months of follow-up, CPAP treatment significantly increased the e' velocity, and was greater than the sham treatment (0.65±1.70 versus -0.61±1.85 cm·s-1, p=0.014). The PWV, 24-h mean diastolic BP, night-time diastolic BP, arterial elastance index and ventricular-vascular coupling index after 3 months of follow-up decreased significantly in the CPAP group.In patients with severe OSA, CPAP treatment for 3 months improved LV diastolic function more than sham treatment, and was accompanied by improvements in arterial stiffness and ventricular-vascular coupling.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01854398.

PMID:
29386335
DOI:
10.1183/13993003.01774-2017
[Indexed for MEDLINE]

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