Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea
BackgroundObstructive sleep apnea (OSA) is a potential risk factor in cardiovascular diseases, including arrhythmia, coronary artery disease, and heart failure (HF). Continuous positive airway pressure (CPAP) therapy is an effective therapy for OSA and the underlying HF, partly through a 5–9% increa...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.781054/full |
| _version_ | 1819104543059738624 |
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| author | Ryo Naito Ryo Naito Takatoshi Kasai Takatoshi Kasai Takatoshi Kasai Tomotaka Dohi Hisashi Takaya Koji Narui Shin-ichi Momomura |
| author_facet | Ryo Naito Ryo Naito Takatoshi Kasai Takatoshi Kasai Takatoshi Kasai Tomotaka Dohi Hisashi Takaya Koji Narui Shin-ichi Momomura |
| author_sort | Ryo Naito |
| collection | DOAJ |
| description | BackgroundObstructive sleep apnea (OSA) is a potential risk factor in cardiovascular diseases, including arrhythmia, coronary artery disease, and heart failure (HF). Continuous positive airway pressure (CPAP) therapy is an effective therapy for OSA and the underlying HF, partly through a 5–9% increase in the left ventricular ejection fraction (LVEF). However, the data on the factors associated with the efficacy of CPAP on LVEF in patients with HF complicated by OSA are scarce. This study aimed to investigate whether LVEF improves in patients with OSA and HF after 1 month of CPAP therapy, and to clarify which factors are associated with the degree of LVEF improvement.MethodThis was a prospective, single-arm, open-label study. We enrolled moderate-to-severe patients with OSA and HF who were being followed up at the cardiovascular center of Toranomon Hospital (Tokyo, Japan). The parameters of sleep study and LVEF were assessed at the baseline and after 1 month of CPAP. The multivariate regression analyses, with changes in LVEF as a dependent variable, were performed to determine the factors that were associated with the degree of LVEF improvement.ResultsWe analyzed 55 consecutive patients with OSA and HF (mean age: 60.7 ± 12.2 years, mean LVEF value: 37.2 ± 9.8%). One month of CPAP treatment decreased the apnea-hypopnea index (AHI) from 45.3 ± 16.1 to 5.4 ± 4.1 per hour, and the LVEF improved from 37.2 ± 9.8 to 43.2 ± 11.7%. The multivariate regression analyses demonstrated that age and body mass index (BMI) were significant determinants of LVEF improvement.ConclusionThe LVEF improved significantly after 1 month of CPAP therapy in Japanese patients with OSA and HF. Multivariate regression analyses indicated that an improvement in LVEF was likely to be observed in young patients with obesity. |
| first_indexed | 2024-12-22T02:08:01Z |
| format | Article |
| id | doaj.art-9c9e4b77cc9c4477a86a8622ab96ef3a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-22T02:08:01Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-9c9e4b77cc9c4477a86a8622ab96ef3a2022-12-21T18:42:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-03-011310.3389/fneur.2022.781054781054Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep ApneaRyo Naito0Ryo Naito1Takatoshi Kasai2Takatoshi Kasai3Takatoshi Kasai4Tomotaka Dohi5Hisashi Takaya6Koji Narui7Shin-ichi Momomura8Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanCardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanCardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanSleep Center, Toranomon Hospital, Tokyo, JapanDepartment of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanSleep Center, Toranomon Hospital, Tokyo, JapanSleep Center, Toranomon Hospital, Tokyo, JapanDepartment of Medicine, Saitama Citizens Medical Center, Saitama, JapanBackgroundObstructive sleep apnea (OSA) is a potential risk factor in cardiovascular diseases, including arrhythmia, coronary artery disease, and heart failure (HF). Continuous positive airway pressure (CPAP) therapy is an effective therapy for OSA and the underlying HF, partly through a 5–9% increase in the left ventricular ejection fraction (LVEF). However, the data on the factors associated with the efficacy of CPAP on LVEF in patients with HF complicated by OSA are scarce. This study aimed to investigate whether LVEF improves in patients with OSA and HF after 1 month of CPAP therapy, and to clarify which factors are associated with the degree of LVEF improvement.MethodThis was a prospective, single-arm, open-label study. We enrolled moderate-to-severe patients with OSA and HF who were being followed up at the cardiovascular center of Toranomon Hospital (Tokyo, Japan). The parameters of sleep study and LVEF were assessed at the baseline and after 1 month of CPAP. The multivariate regression analyses, with changes in LVEF as a dependent variable, were performed to determine the factors that were associated with the degree of LVEF improvement.ResultsWe analyzed 55 consecutive patients with OSA and HF (mean age: 60.7 ± 12.2 years, mean LVEF value: 37.2 ± 9.8%). One month of CPAP treatment decreased the apnea-hypopnea index (AHI) from 45.3 ± 16.1 to 5.4 ± 4.1 per hour, and the LVEF improved from 37.2 ± 9.8 to 43.2 ± 11.7%. The multivariate regression analyses demonstrated that age and body mass index (BMI) were significant determinants of LVEF improvement.ConclusionThe LVEF improved significantly after 1 month of CPAP therapy in Japanese patients with OSA and HF. Multivariate regression analyses indicated that an improvement in LVEF was likely to be observed in young patients with obesity.https://www.frontiersin.org/articles/10.3389/fneur.2022.781054/fullCPAPOSA (obstructive sleep apnea)short-termHFrEF (heart failure with reduced ejection fraction)LVEF (left ventricular ejection fraction) |
| spellingShingle | Ryo Naito Ryo Naito Takatoshi Kasai Takatoshi Kasai Takatoshi Kasai Tomotaka Dohi Hisashi Takaya Koji Narui Shin-ichi Momomura Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea Frontiers in Neurology CPAP OSA (obstructive sleep apnea) short-term HFrEF (heart failure with reduced ejection fraction) LVEF (left ventricular ejection fraction) |
| title | Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea |
| title_full | Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea |
| title_fullStr | Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea |
| title_full_unstemmed | Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea |
| title_short | Factors Associated With the Improvement of Left Ventricular Systolic Function by Continuous Positive Airway Pressure Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Obstructive Sleep Apnea |
| title_sort | factors associated with the improvement of left ventricular systolic function by continuous positive airway pressure therapy in patients with heart failure with reduced ejection fraction and obstructive sleep apnea |
| topic | CPAP OSA (obstructive sleep apnea) short-term HFrEF (heart failure with reduced ejection fraction) LVEF (left ventricular ejection fraction) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.781054/full |
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