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Continuous Positive Airway Pressure Therapy Restores Cardiac Mechanical Function in Patients With Severe Obstructive Sleep Apnea: A Randomized, Sham-Controlled Study

Authors
 Darae Kim  ;  Chi Young Shim  ;  Yang-Je Cho  ;  Sungha Park  ;  Chan Joo Lee  ;  Joo Hee Park  ;  Hyoung Joo Cho  ;  Jong-Won Ha  ;  Geu-Ru Hong 
Citation
 Journal of the American Society of Echocardiography, Vol.32(7) : 826-835, 2019 
Journal Title
 Journal of the American Society of Echocardiography 
ISSN
 0894-7317 
Issue Date
2019
Keywords
Continuous positive airway pressure ; Left ventricle ; Obstructive sleep apnea ; Right ventricle ; Speckle-tracking echocardiography
Abstract
BACKGROUND: Continuous positive airway pressure (CPAP) therapy might decrease left ventricular (LV) and right ventricular (RV) loads and improve cardiac mechanical function in patients with obstructive sleep apnea (OSA). However, the benefits of CPAP therapy for cardiac mechanical function in patients with OSA have not previously been proved in a randomized, sham-controlled clinical trial. This study therefore investigated the effects of CPAP therapy on LV and RV mechanical function in patients with severe OSA and compared them with the effects of a sham intervention. METHODS: In this randomized sham-controlled trial, we analyzed LV and RV function by conventional and speckle-tracking echocardiography before and after 3 months of treatment in 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 randomization. RESULTS: After 3 months, CPAP treatment significantly improved LV global longitudinal strain (GLS) compared with the sham treatment (-20.0% ± 2.1% vs -18.0% ± 2.5%; P = .004), although there were no differences in LV dimension or ejection fraction. CPAP treatment reduced RV size and improved the fractional area change (51.3% ± 7.9% vs 46.9% ± 6.7%; P = .038) compared with the sham treatment. CPAP treatment did not ameliorate the RV GLS compared with the sham treatment. CONCLUSIONS: In patients with severe OSA, CPAP treatment for 3 months improved LV and RV function compared with sham treatment. LV mechanical function assessed by speckle-tracking echocardiography and RV fractional area change assessed by two-dimensional echocardiography were significantly improved by CPAP treatment.
Full Text
https://www.sciencedirect.com/science/article/pii/S0894731719301610
DOI
10.1016/j.echo.2019.03.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Cho, Yang Je(조양제)
Cho, Hyung Ju(조형주) ORCID logo https://orcid.org/0000-0002-2851-3225
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171336
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