Impact of continuous positive airway pressure treatment on right ventricle performance in patients with obstructive sleep apnoea, assessed by three-dimensional echocardiography
| Autor: | Sergio Tufik, Marcelo Luiz Campos Vieira, Claudio Henrique Fischer, Wercules Antônio Oliveira, Dalva Poyares, Fátima Dumas Cintra, Valdir Ambrósio Moisés, Orlando Campos, Antonio Carlos Carvalho |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Pulmonary Circulation medicine.medical_specialty Heart Ventricles Polysomnography medicine.medical_treatment Echocardiography Three-Dimensional Hemodynamics Internal medicine medicine Humans Continuous positive airway pressure Sleep Apnea Obstructive Ejection fraction Continuous Positive Airway Pressure business.industry General Medicine Middle Aged medicine.disease Pulmonary hypertension respiratory tract diseases Obstructive sleep apnea medicine.anatomical_structure Ventricle Case-Control Studies Anesthesia Heart failure Ventricular Function Right Cardiology Vascular resistance Female Vascular Resistance business |
| Zdroj: | Sleep Medicine. 13:510-516 |
| ISSN: | 1389-9457 |
| DOI: | 10.1016/j.sleep.2011.12.010 |
| Popis: | Obstructive sleep apnoea (OSA) is a predictor of right ventricle (RV) impairment. However, there is scant information on the effect of OSA treatment on RV performance. We sought to evaluate the impact of OSA treatment with a continuous positive airway pressure (CPAP) device on RV volume and function, as well as on variables related to pulmonary vascular haemodynamics.Fifty-six OSA patients and 50 controls were studied. All individuals underwent three-dimensional echocardiogram (3DE) to estimate RV volumes, function, pulmonary vascular resistance, and tricuspid regurgitation velocity. A total of 30 patients with apnoea-hypopnoea index greater than 20 were randomly selected to receive placebo (n=15) or effective CPAP (n=15) for 24 weeks. They underwent 3DE examination on three different occasions: at baseline, after 12 weeks, and after 24 weeks of CPAP or placebo.Higher pulmonary vascular resistance (2.1 Wood's ± 0.5 vs. 1.8 Wood's ± 0.4), larger end-diastolic RV volume index (52.2 mL/m(2) ± 7.3 vs. 49.9 mL/m(2) ± 6.0), larger end-systolic RV volume index (18.7 mL/m(2) ± 4.3 vs. 15.4 mL/m(2) ± 3.6), and lower RV ejection fraction (64.3% ± 6.8 vs. 68.4% ± 5.9) were observed in the OSA group compared to non-OSA controls (P0.05, all). In the effective CPAP group we observed the following changes from the baseline to the 24-week echo evaluation: (A) reduction in pulmonary vascular resistance (2.2 Wood's ± 0.3 to 1.8 Wood's ± 0.3); (B) reduction in the RV end-systolic volume index (20.3 mL/m(2) ± 4.5 to 16 mL/m(2) ± 2.1); and (C) increase in RV ejection fraction (63.0% ± 7.2 to 70.8% ± 0.9) (P0.05 for all).Twenty-four-week treatment with CPAP improved RV performance but did not change RV structural variables. |
| Databáze: | OpenAIRE |
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