Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study
Introduction Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiv...
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| Veröffentlicht in: | Sleep & breathing 2015-03, Vol.19 (1), p.343-350 |
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| creator | Karamanzanis, George Panou, Fotios Lazaros, George Oikonomou, Evangelos Nikolopoulos, Ioannis Mihaelidou, Makrina Ntounis, George Lekakis, John |
| description | Introduction
Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiving CPAP.
Materials and methods
This is a prospective longitudinal study of 44 patients aged 55.8 ± 10.6 years (79.5 % men), with newly diagnosed moderate and severe OSA (apnea–hypopnea index ≥15 with polysomnographic evaluation). All patients enrolled received CPAP therapy. The study protocol included a complete conventional and tissue Doppler echocardiographic study at baseline and 12 months after CPAP treatment.
Results
Among patients enrolled, 31 completed the prespecified study protocol. After CPAP therapy, a decrease in pulmonary artery systolic pressure (
p
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| doi_str_mv | 10.1007/s11325-014-1026-5 |
| format | Article |
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Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiving CPAP.
Materials and methods
This is a prospective longitudinal study of 44 patients aged 55.8 ± 10.6 years (79.5 % men), with newly diagnosed moderate and severe OSA (apnea–hypopnea index ≥15 with polysomnographic evaluation). All patients enrolled received CPAP therapy. The study protocol included a complete conventional and tissue Doppler echocardiographic study at baseline and 12 months after CPAP treatment.
Results
Among patients enrolled, 31 completed the prespecified study protocol. After CPAP therapy, a decrease in pulmonary artery systolic pressure (
p
< 0.001), right ventricular (RV) diameter (
p
= 0.012), inferior vena cava diameter (
p
= 0.005), and RV wall thickness (
p
= 0.006) was observed. In addition, tricuspid annular plane systolic excursion values (
p
= 0.048) and tissue E/A ratio at the tricuspid annulus (
p
= 0.01) were significantly increased. Moreover, a reduction in left ventricular (LV) mass was observed (
p
< 0.001). With respect to somatometric parameters, body mass index and waist diameter (
p
< 0.001 for both) were reduced. Importantly, the improvement in apnea–hypopnea index was associated with the improvement in pulmonary artery systolic pressure, independently from confounders such as age, gender, and the reduction in body mass index.
Discussion
CPAP therapy in OSA patients was found to improve right heart chambers remodeling and performance as well as somatometric characteristics. The impact of CPAP on LV performance seems less pronounced.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-014-1026-5</identifier><identifier>PMID: 24989483</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Airway management ; Continuous Positive Airway Pressure ; Dentistry ; Echocardiography, Doppler - methods ; Female ; Heart Ventricles - diagnostic imaging ; Hemodynamics - physiology ; Humans ; Internal Medicine ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Original Article ; Otorhinolaryngology ; Pediatrics ; Pneumology/Respiratory System ; Polysomnography ; Prospective Studies ; Pulmonary hypertension ; Pulmonary Wedge Pressure - physiology ; Sensitivity and Specificity ; Sleep apnea ; Sleep Apnea, Obstructive - diagnostic imaging ; Sleep Apnea, Obstructive - therapy ; Tricuspid Valve - diagnostic imaging ; Ultrasonic imaging ; Vena Cava, Inferior - diagnostic imaging ; Ventricular Remodeling</subject><ispartof>Sleep & breathing, 2015-03, Vol.19 (1), p.343-350</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f1bca3a4a3edaf6d71aa90d23ced509cb69c9cbfbe3ded13ec8d720710057d063</citedby><cites>FETCH-LOGICAL-c372t-f1bca3a4a3edaf6d71aa90d23ced509cb69c9cbfbe3ded13ec8d720710057d063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-014-1026-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-014-1026-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24989483$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karamanzanis, George</creatorcontrib><creatorcontrib>Panou, Fotios</creatorcontrib><creatorcontrib>Lazaros, George</creatorcontrib><creatorcontrib>Oikonomou, Evangelos</creatorcontrib><creatorcontrib>Nikolopoulos, Ioannis</creatorcontrib><creatorcontrib>Mihaelidou, Makrina</creatorcontrib><creatorcontrib>Ntounis, George</creatorcontrib><creatorcontrib>Lekakis, John</creatorcontrib><title>Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Introduction
Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiving CPAP.
Materials and methods
This is a prospective longitudinal study of 44 patients aged 55.8 ± 10.6 years (79.5 % men), with newly diagnosed moderate and severe OSA (apnea–hypopnea index ≥15 with polysomnographic evaluation). All patients enrolled received CPAP therapy. The study protocol included a complete conventional and tissue Doppler echocardiographic study at baseline and 12 months after CPAP treatment.
Results
Among patients enrolled, 31 completed the prespecified study protocol. After CPAP therapy, a decrease in pulmonary artery systolic pressure (
p
< 0.001), right ventricular (RV) diameter (
p
= 0.012), inferior vena cava diameter (
p
= 0.005), and RV wall thickness (
p
= 0.006) was observed. In addition, tricuspid annular plane systolic excursion values (
p
= 0.048) and tissue E/A ratio at the tricuspid annulus (
p
= 0.01) were significantly increased. Moreover, a reduction in left ventricular (LV) mass was observed (
p
< 0.001). With respect to somatometric parameters, body mass index and waist diameter (
p
< 0.001 for both) were reduced. Importantly, the improvement in apnea–hypopnea index was associated with the improvement in pulmonary artery systolic pressure, independently from confounders such as age, gender, and the reduction in body mass index.
Discussion
CPAP therapy in OSA patients was found to improve right heart chambers remodeling and performance as well as somatometric characteristics. The impact of CPAP on LV performance seems less pronounced.</description><subject>Adult</subject><subject>Aged</subject><subject>Airway management</subject><subject>Continuous Positive Airway Pressure</subject><subject>Dentistry</subject><subject>Echocardiography, Doppler - methods</subject><subject>Female</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Original Article</subject><subject>Otorhinolaryngology</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Polysomnography</subject><subject>Prospective Studies</subject><subject>Pulmonary hypertension</subject><subject>Pulmonary Wedge Pressure - physiology</subject><subject>Sensitivity and Specificity</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - diagnostic imaging</subject><subject>Sleep Apnea, Obstructive - therapy</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Ultrasonic imaging</subject><subject>Vena Cava, Inferior - diagnostic imaging</subject><subject>Ventricular Remodeling</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kc1u1DAUhSMEoqXlAdggS2y6SfFPnEyWVWmhUiU2dG3d2DcdV4ltbKfVPBjvV8-kIITExrbk75yje09VfWD0nFHafU6MCS5rypqaUd7W8lV1zCTnNeto__rwpnUvGT-q3qX0QAu46dnb6og3_aZvNuK4-nUzB9CZ-JFo77J1i18SCT7ZbB-RgI1PsCMhYkpLRJIjQp7RFYEj885riMbCRALG0ccZnEZiHQmQbYESebJ5S_yQclz0wTBNiIFAcAjn5GKf-VhA610xAWdItiUIyRcfwoSRoN6uGf4-QthaTVJezO60ejPClPD9y31S3V1f_bj8Vt9-_3pzeXFba9HxXI9s0CCgAYEGxtZ0DKCnhguNRtJeD22vyzkOKAwaJlBvTMdpV5YrO0NbcVKdrb4h-p8LpqxmmzROEzgse1KslS1tZMu6gn76B33wSyxjHSjZtD1taKHYSunoU4o4qhDtDHGnGFX7TtXaqSpVqX2nShbNxxfnZZjR_FH8LrEAfAVS-XL3GP-K_q_rM76Aspc</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Karamanzanis, George</creator><creator>Panou, Fotios</creator><creator>Lazaros, George</creator><creator>Oikonomou, Evangelos</creator><creator>Nikolopoulos, Ioannis</creator><creator>Mihaelidou, Makrina</creator><creator>Ntounis, George</creator><creator>Lekakis, John</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study</title><author>Karamanzanis, George ; Panou, Fotios ; Lazaros, George ; Oikonomou, Evangelos ; Nikolopoulos, Ioannis ; Mihaelidou, Makrina ; Ntounis, George ; Lekakis, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f1bca3a4a3edaf6d71aa90d23ced509cb69c9cbfbe3ded13ec8d720710057d063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Airway management</topic><topic>Continuous Positive Airway Pressure</topic><topic>Dentistry</topic><topic>Echocardiography, Doppler - methods</topic><topic>Female</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Original Article</topic><topic>Otorhinolaryngology</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Polysomnography</topic><topic>Prospective Studies</topic><topic>Pulmonary hypertension</topic><topic>Pulmonary Wedge Pressure - physiology</topic><topic>Sensitivity and Specificity</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - diagnostic imaging</topic><topic>Sleep Apnea, Obstructive - therapy</topic><topic>Tricuspid Valve - diagnostic imaging</topic><topic>Ultrasonic imaging</topic><topic>Vena Cava, Inferior - diagnostic imaging</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karamanzanis, George</creatorcontrib><creatorcontrib>Panou, Fotios</creatorcontrib><creatorcontrib>Lazaros, George</creatorcontrib><creatorcontrib>Oikonomou, Evangelos</creatorcontrib><creatorcontrib>Nikolopoulos, Ioannis</creatorcontrib><creatorcontrib>Mihaelidou, Makrina</creatorcontrib><creatorcontrib>Ntounis, George</creatorcontrib><creatorcontrib>Lekakis, John</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karamanzanis, George</au><au>Panou, Fotios</au><au>Lazaros, George</au><au>Oikonomou, Evangelos</au><au>Nikolopoulos, Ioannis</au><au>Mihaelidou, Makrina</au><au>Ntounis, George</au><au>Lekakis, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>19</volume><issue>1</issue><spage>343</spage><epage>350</epage><pages>343-350</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Introduction
Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiving CPAP.
Materials and methods
This is a prospective longitudinal study of 44 patients aged 55.8 ± 10.6 years (79.5 % men), with newly diagnosed moderate and severe OSA (apnea–hypopnea index ≥15 with polysomnographic evaluation). All patients enrolled received CPAP therapy. The study protocol included a complete conventional and tissue Doppler echocardiographic study at baseline and 12 months after CPAP treatment.
Results
Among patients enrolled, 31 completed the prespecified study protocol. After CPAP therapy, a decrease in pulmonary artery systolic pressure (
p
< 0.001), right ventricular (RV) diameter (
p
= 0.012), inferior vena cava diameter (
p
= 0.005), and RV wall thickness (
p
= 0.006) was observed. In addition, tricuspid annular plane systolic excursion values (
p
= 0.048) and tissue E/A ratio at the tricuspid annulus (
p
= 0.01) were significantly increased. Moreover, a reduction in left ventricular (LV) mass was observed (
p
< 0.001). With respect to somatometric parameters, body mass index and waist diameter (
p
< 0.001 for both) were reduced. Importantly, the improvement in apnea–hypopnea index was associated with the improvement in pulmonary artery systolic pressure, independently from confounders such as age, gender, and the reduction in body mass index.
Discussion
CPAP therapy in OSA patients was found to improve right heart chambers remodeling and performance as well as somatometric characteristics. The impact of CPAP on LV performance seems less pronounced.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24989483</pmid><doi>10.1007/s11325-014-1026-5</doi><tpages>8</tpages></addata></record> |
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| ispartof | Sleep & breathing, 2015-03, Vol.19 (1), p.343-350 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Airway management Continuous Positive Airway Pressure Dentistry Echocardiography, Doppler - methods Female Heart Ventricles - diagnostic imaging Hemodynamics - physiology Humans Internal Medicine Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Neurology Original Article Otorhinolaryngology Pediatrics Pneumology/Respiratory System Polysomnography Prospective Studies Pulmonary hypertension Pulmonary Wedge Pressure - physiology Sensitivity and Specificity Sleep apnea Sleep Apnea, Obstructive - diagnostic imaging Sleep Apnea, Obstructive - therapy Tricuspid Valve - diagnostic imaging Ultrasonic imaging Vena Cava, Inferior - diagnostic imaging Ventricular Remodeling |
| title | Impact of continuous positive airway pressure treatment on myocardial performance in patients with obstructive sleep apnea. A conventional and tissue Doppler echocardiographic study |
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