Chest
Original ResearchSleep MedicineCardiac Effects of Continuous and Bilevel Positive Airway Pressure for Patients With Heart Failure and Obstructive Sleep Apnea: A Pilot Study
Section snippets
Subjects
Patients with left ventricular systolic dysfunction, stable American Heart Association class II or III, and newly diagnosed OSA were targeted for recruitment. Inclusion criteria were baseline LVEF ≤ 45%; no hospitalizations or medication changes in the 3 months prior to enrollment; and newly diagnosed OSA (diagnostic polysomnography with apnea-hypopnea index [AHI] > 10/h; > 50% of total events obstructive). Additionally, adequate resolution of respiratory events with PAP titration was required.
Patient Characteristics
Participants were 24 patients with systolic dysfunction and newly diagnosed OSA. Table 1 details participant characteristics. Thirteen participants (6 women) were enrolled in the bilevel PAP group, and 11 patients were in the CPAP group (4 women). All patients had LVEF ≤ 45%. There were no apparent imbalances between the two groups in LVEF, weight, severity of OSA, or baseline score on ESS score. All patients were followed up by the OSU Heart Failure Program and were receiving optimal doses of
Discussion
This pilot randomized controlled trial compared the cardiac effect of bilevel PAP to CPAP in patients with systolic dysfunction and OSA. Patients were randomized to 3 months of either fixed CPAP or bilevel PAP. There were no apparent imbalances in baseline characteristics between the two groups. LVEF improved significantly more in the bilevel PAP group than the CPAP group. The change in LVEF was not significant in the CPAP group. This pilot study is the first intermediate-term evaluation of the
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This project was supported by research grant from Respironics, Inc.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
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Drs. Khayat and Abraham have received research grants from Respironics, Inc.