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Cardiac structure and function improvements in coronary artery disease combined with severe obstructive sleep apnea/hypopnea syndrome patients via noninvasive positive pressure ventilation therapy

Liu, Xinbinga; Feng, Liuliua; Cao, Guoliangb; Huang, Hongmana; Xu, Qitana; Yu, Jianhuaa; Zhang, Shufua; Zhou, Mingchengc

doi: 10.1097/MCA.0000000000000129
Original Research

Objective: The aim of this study was to investigate the effects of a noninvasive positive pressure ventilation therapy on cardiac structure and function in patients with coronary heart disease combined with obstructive sleep apnea/hypopnea syndrome (OSAHS).

Patients and methods: Eighty patients with coronary heart disease OSAHS were divided randomly into treatment (n=40) and control (n=40) groups. Both groups received standard medications. The treatment group received additional noninvasive mechanical ventilation support for at least 3 h (3–6 h) every night. On the first day after selection and 3 months afterwards, participants were examined with echocardiograms, 24-h ambulatory blood pressure monitoring, and blood analyses. Primary endpoints were left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left atrial diameter as well as serum concentrations of N-terminal prohormone of brain natriuretic peptide, and high-sensitive C-reactive protein. Secondary endpoints included cardiac death, nonfatal myocardial infarction, and hospitalization.

Results: After the 3-month study period, patients in the treatment group showed significantly improved left ventricular end-diastolic diameter (P=0.02), left ventricular end-systolic diameter (P=0.035), left ventricular ejection fraction (P=0.05), and left atrial diameter (P=0.02) values, and their serum N-terminal prohormone of brain natriuretic peptide (P=0.01) and high-sensitive C-reactive protein (P=0.04) concentrations were significantly improved compared with the control group. During the 3 months, three cardiovascular complications occurred in the treatment group versus nine in the control group (P<0.05).

Conclusion: For patients with coronary heart disease combined with OSAHS, noninvasive mechanical ventilation therapy can significantly improve heart functions and reduce the occurrence of cardiovascular complications.

aDepartment of Cardiology, Shanghai Shi Dong Hospital

bDepartment of Geriatrics, Shanghai No. 3 People’s Hospital

cDepartment of Cardiology, An Tu Hospital, Shanghai, China

Correspondence to Mingcheng Zhou, MD, Department of Cardiology, An Tu Hospital, No. 200 Yanji East Road, Shanghai 200093, China Tel/fax: +86 21 65489845; e-mail: zhoumingchengbm@163.com

Received February 17, 2014

Received in revised form April 18, 2014

Accepted April 29, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins