Beneficial effect of bilevel positive airway pressure on left ventricular function in ambulatory patients with idiopathic dilated cardiomyopathy and central sleep apnea-hypopnea: A preliminary study

Akiko Noda, Hideo Izawa, Hiroyuki Asano, Seiichi Nakata, Akihiro Hirashiki, Yosuke Murase, Shigeo Iino, Kohzo Nagata, Toyoaki Murohara, Yasuo Koike, Mitsuhiro Yokota

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Sleep-disordered breathing is common in individuals with left ventricular (LV) dysfunction and has been treated with nocturnal positive airway pressure. We investigated whether treatment of central sleep apnea-hypopnea with bilevel positive airway pressure (BPAP) in ambulatory patients with idiopathic dilated cardiomyopathy (IDCM) might improve LV function. Methods: Fifty-two consecutive patients with IDCM who underwent both cardiac catheterization and standard polysomnography were enrolled in the study; individuals with obstructive sleep apnea syndrome were excluded. Subjects with an apnea-hypopnea index (AHI) ≥ 20 episodes per hour were randomized to receive medical therapy either alone (n = 11) or together with BPAP (n = 10). Results: LV end-diastolic pressure, pulmonary capillary wedge pressure, and plasma concentration of brain natriuretic peptide were significantly greater, and LV ejection fraction (LVEF) was significantly lower in patients with an AHI ≥ 20/h (n = 21, 40.4%) than in those with an AHI < 20/h (n = 31, 59.6%). LVEF (30.5 ± 1.6% vs 50.8 ± 3.5%, p < 0.001) [mean ± SE] and plasma concentration of brain natriuretic peptide (162.8 ± 44.5 pg/mL vs 32.7 ± 17.6 pg/mL, p = 0.02) were significantly increased and decreased, respectively, after treatment with BPAP (daily use, 4.8 ± 0.3 h) for 3 months, whereas these parameters remained unchanged in the control subjects. Conclusions: Our findings suggest that treatment of coexisting central sleep apnea-hypopnea with BPAP improves LV function in ambulatory patients with IDCM. BPAP should thus be considered as a nonpharmacologic adjunct to conventional drug therapy in such patients.

Original languageEnglish
Pages (from-to)1694-1701
Number of pages8
JournalChest
Volume131
Issue number6
DOIs
Publication statusPublished - 01-01-2007
Externally publishedYes

Fingerprint

Central Sleep Apnea
Sleep Apnea Syndromes
Dilated Cardiomyopathy
Left Ventricular Function
Pressure
Apnea
Brain Natriuretic Peptide
Pulmonary Wedge Pressure
Polysomnography
Left Ventricular Dysfunction
Obstructive Sleep Apnea
Therapeutics
Cardiac Catheterization
Stroke Volume
Blood Pressure
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Noda, Akiko ; Izawa, Hideo ; Asano, Hiroyuki ; Nakata, Seiichi ; Hirashiki, Akihiro ; Murase, Yosuke ; Iino, Shigeo ; Nagata, Kohzo ; Murohara, Toyoaki ; Koike, Yasuo ; Yokota, Mitsuhiro. / Beneficial effect of bilevel positive airway pressure on left ventricular function in ambulatory patients with idiopathic dilated cardiomyopathy and central sleep apnea-hypopnea : A preliminary study. In: Chest. 2007 ; Vol. 131, No. 6. pp. 1694-1701.
@article{4aee4ad54efd44c1a91096e612f4482b,
title = "Beneficial effect of bilevel positive airway pressure on left ventricular function in ambulatory patients with idiopathic dilated cardiomyopathy and central sleep apnea-hypopnea: A preliminary study",
abstract = "Background: Sleep-disordered breathing is common in individuals with left ventricular (LV) dysfunction and has been treated with nocturnal positive airway pressure. We investigated whether treatment of central sleep apnea-hypopnea with bilevel positive airway pressure (BPAP) in ambulatory patients with idiopathic dilated cardiomyopathy (IDCM) might improve LV function. Methods: Fifty-two consecutive patients with IDCM who underwent both cardiac catheterization and standard polysomnography were enrolled in the study; individuals with obstructive sleep apnea syndrome were excluded. Subjects with an apnea-hypopnea index (AHI) ≥ 20 episodes per hour were randomized to receive medical therapy either alone (n = 11) or together with BPAP (n = 10). Results: LV end-diastolic pressure, pulmonary capillary wedge pressure, and plasma concentration of brain natriuretic peptide were significantly greater, and LV ejection fraction (LVEF) was significantly lower in patients with an AHI ≥ 20/h (n = 21, 40.4{\%}) than in those with an AHI < 20/h (n = 31, 59.6{\%}). LVEF (30.5 ± 1.6{\%} vs 50.8 ± 3.5{\%}, p < 0.001) [mean ± SE] and plasma concentration of brain natriuretic peptide (162.8 ± 44.5 pg/mL vs 32.7 ± 17.6 pg/mL, p = 0.02) were significantly increased and decreased, respectively, after treatment with BPAP (daily use, 4.8 ± 0.3 h) for 3 months, whereas these parameters remained unchanged in the control subjects. Conclusions: Our findings suggest that treatment of coexisting central sleep apnea-hypopnea with BPAP improves LV function in ambulatory patients with IDCM. BPAP should thus be considered as a nonpharmacologic adjunct to conventional drug therapy in such patients.",
author = "Akiko Noda and Hideo Izawa and Hiroyuki Asano and Seiichi Nakata and Akihiro Hirashiki and Yosuke Murase and Shigeo Iino and Kohzo Nagata and Toyoaki Murohara and Yasuo Koike and Mitsuhiro Yokota",
year = "2007",
month = "1",
day = "1",
doi = "10.1378/chest.06-2271",
language = "English",
volume = "131",
pages = "1694--1701",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

}

Beneficial effect of bilevel positive airway pressure on left ventricular function in ambulatory patients with idiopathic dilated cardiomyopathy and central sleep apnea-hypopnea : A preliminary study. / Noda, Akiko; Izawa, Hideo; Asano, Hiroyuki; Nakata, Seiichi; Hirashiki, Akihiro; Murase, Yosuke; Iino, Shigeo; Nagata, Kohzo; Murohara, Toyoaki; Koike, Yasuo; Yokota, Mitsuhiro.

In: Chest, Vol. 131, No. 6, 01.01.2007, p. 1694-1701.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Beneficial effect of bilevel positive airway pressure on left ventricular function in ambulatory patients with idiopathic dilated cardiomyopathy and central sleep apnea-hypopnea

T2 - A preliminary study

AU - Noda, Akiko

AU - Izawa, Hideo

AU - Asano, Hiroyuki

AU - Nakata, Seiichi

AU - Hirashiki, Akihiro

AU - Murase, Yosuke

AU - Iino, Shigeo

AU - Nagata, Kohzo

AU - Murohara, Toyoaki

AU - Koike, Yasuo

AU - Yokota, Mitsuhiro

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Background: Sleep-disordered breathing is common in individuals with left ventricular (LV) dysfunction and has been treated with nocturnal positive airway pressure. We investigated whether treatment of central sleep apnea-hypopnea with bilevel positive airway pressure (BPAP) in ambulatory patients with idiopathic dilated cardiomyopathy (IDCM) might improve LV function. Methods: Fifty-two consecutive patients with IDCM who underwent both cardiac catheterization and standard polysomnography were enrolled in the study; individuals with obstructive sleep apnea syndrome were excluded. Subjects with an apnea-hypopnea index (AHI) ≥ 20 episodes per hour were randomized to receive medical therapy either alone (n = 11) or together with BPAP (n = 10). Results: LV end-diastolic pressure, pulmonary capillary wedge pressure, and plasma concentration of brain natriuretic peptide were significantly greater, and LV ejection fraction (LVEF) was significantly lower in patients with an AHI ≥ 20/h (n = 21, 40.4%) than in those with an AHI < 20/h (n = 31, 59.6%). LVEF (30.5 ± 1.6% vs 50.8 ± 3.5%, p < 0.001) [mean ± SE] and plasma concentration of brain natriuretic peptide (162.8 ± 44.5 pg/mL vs 32.7 ± 17.6 pg/mL, p = 0.02) were significantly increased and decreased, respectively, after treatment with BPAP (daily use, 4.8 ± 0.3 h) for 3 months, whereas these parameters remained unchanged in the control subjects. Conclusions: Our findings suggest that treatment of coexisting central sleep apnea-hypopnea with BPAP improves LV function in ambulatory patients with IDCM. BPAP should thus be considered as a nonpharmacologic adjunct to conventional drug therapy in such patients.

AB - Background: Sleep-disordered breathing is common in individuals with left ventricular (LV) dysfunction and has been treated with nocturnal positive airway pressure. We investigated whether treatment of central sleep apnea-hypopnea with bilevel positive airway pressure (BPAP) in ambulatory patients with idiopathic dilated cardiomyopathy (IDCM) might improve LV function. Methods: Fifty-two consecutive patients with IDCM who underwent both cardiac catheterization and standard polysomnography were enrolled in the study; individuals with obstructive sleep apnea syndrome were excluded. Subjects with an apnea-hypopnea index (AHI) ≥ 20 episodes per hour were randomized to receive medical therapy either alone (n = 11) or together with BPAP (n = 10). Results: LV end-diastolic pressure, pulmonary capillary wedge pressure, and plasma concentration of brain natriuretic peptide were significantly greater, and LV ejection fraction (LVEF) was significantly lower in patients with an AHI ≥ 20/h (n = 21, 40.4%) than in those with an AHI < 20/h (n = 31, 59.6%). LVEF (30.5 ± 1.6% vs 50.8 ± 3.5%, p < 0.001) [mean ± SE] and plasma concentration of brain natriuretic peptide (162.8 ± 44.5 pg/mL vs 32.7 ± 17.6 pg/mL, p = 0.02) were significantly increased and decreased, respectively, after treatment with BPAP (daily use, 4.8 ± 0.3 h) for 3 months, whereas these parameters remained unchanged in the control subjects. Conclusions: Our findings suggest that treatment of coexisting central sleep apnea-hypopnea with BPAP improves LV function in ambulatory patients with IDCM. BPAP should thus be considered as a nonpharmacologic adjunct to conventional drug therapy in such patients.

UR - http://www.scopus.com/inward/record.url?scp=34250805418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250805418&partnerID=8YFLogxK

U2 - 10.1378/chest.06-2271

DO - 10.1378/chest.06-2271

M3 - Article

C2 - 17400681

AN - SCOPUS:34250805418

VL - 131

SP - 1694

EP - 1701

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -