Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial
| Autor: | Juan F. Masa, Babak Mokhlesi, Iván Benítez, Maria Victoria Mogollon, Francisco Javier Gomez de Terreros, Maria Ángeles Sánchez-Quiroga, Auxiliadora Romero, Candela Caballero-Eraso, Maria Luz Alonso-Álvarez, Estrella Ordax-Carbajo, Teresa Gomez-Garcia, Mónica González, Soledad López-Martín, José M. Marin, Sergi Martí, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Javier Barca, Francisco-José Vázquez-Polo, Miguel A. Negrín, María Martel-Escobar, Ferran Barbe, Jaime Corral, Agustin Sojo, Nicolás González-Mangado, Maria F. Troncoso, Maria-Ángeles Martinez-Martinez, Elena Ojeda-Castillejo, Daniel López Padilla, Santiago J. Carrizo, Begoña Gallego, Mercedes Pallero, Odile Romero, Maria Antonia Ramón, Eva Arias, Jesús Muñoz-Méndez, Cristina Senent, Jose N. Sancho-Chust, Nieves Belén Navarro Soriano, Emilia Barrot, José M. Benítez, Jesús Sanchez-Gómez, Rafael Golpe, María Antonia Gómez Mendieta, Silvia Gomez, Mónica Bengoa |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Continuous positive airway pressure Critical Care and Intensive Care Medicine Pulmonary hypertension law.invention Hypercapnia 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Positive airway pressure medicine 030212 general & internal medicine Obesity hypoventilation syndrome business.industry Sleep apnea medicine.disease respiratory tract diseases Clinical trial 030228 respiratory system Cardiology Diastolic dysfunction medicine.symptom business Noninvasive ventilation |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 1535-4970 1073-449X |
| DOI: | 10.1164/rccm.201906-1122oc |
| Popis: | Spanish Sleep Network. [Rationale] Obesity hypoventilation syndrome (OHS) has been associated with cardiac dysfunction. However, randomized trials assessing the impact of long-term noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) on cardiac structure and function assessed by echocardiography are lacking. Rationale: Obesity hypoventilation syndrome (OHS) has been associated with cardiac dysfunction. However, randomized trials assessing the impact of long-term noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) on cardiac structure and function assessed by echocardiography are lacking. [Objectives] In a prespecified secondary analysis of the largest multicenter randomized controlled trial of OHS (Pickwick Project; N = 221 patients with OHS and coexistent severe obstructive sleep apnea), we compared the effectiveness of three years of NIV and CPAP on structural and functional echocardiographic changes. [Methods] At baseline and annually during three sequential years, patients underwent transthoracic two-dimensional and Doppler echocardiography. Echocardiographers at each site were blinded to the treatment allocation. Statistical analysis was performed using a linear mixed-effects model with a treatment group and repeated measures interaction to determine the differential effect between CPAP and NIV. Measurements and Main Results: A total of 196 patients were analyzed: 102 were treated with CPAP and 94 were treated with NIV. Systolic pulmonary artery pressure decreased from 40.5 ± 1.47 mm Hg at baseline to 35.3 ± 1.33 mm Hg at three years with CPAP, and from 41.5 ± 1.56 mm Hg to 35.5 ± 1.42 with NIV (P [Conclusions] In patients with OHS who have concomitant severe obstructive sleep apnea, long-term treatment with NIV and CPAP led to similar degrees of improvement in pulmonary hypertension and left ventricular diastolic dysfunction. |
| Databáze: | OpenAIRE |
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