Improvements of right ventricular function after intervention with CPAP in patients with obstructive sleep apnoea.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Echo Research and Practice Pub Date : 2024-10-01 DOI:10.1186/s44156-024-00058-9
Greg Murphy, Peter Coss, Gerard King, Mark Coyle, Anne-Marie McLaughlin, Ross Murphy
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Abstract

Background: Obstructive sleep apnoea (OSA) is present in 40-80% of patients with cardiovascular morbidity and is associated with adverse effects on cardiovascular health. Continuous positive airway pressure (CPAP) maintains airway patency during sleep and is hypothesised to improve cardiac function. In the present study, we report on the impact of 12 weeks of CPAP and improvements in echocardiographic parameters of the right ventricle (RV).

Methods: Nineteen newly diagnosed patients with OSA and a respiratory disturbance index (RDI) greater than 10 were enrolled. Echocardiography was performed before treatment and with a follow-up assessment after 12 weeks of CPAP. Echocardiographic and Doppler measurements were made following the American Society for Echocardiography guidelines. The primary outcome was isovolumetric acceleration (IVA). Secondary outcomes include tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV % strain, TEI index and RV dimension (RVD1).

Results: There was significant improvement in isovolumetric acceleration of 0.5ms2 (P = 0.0012 (95% CI -0.72, -0.20)) and significant improvement of 2.05 mm in TAPSE (p = 0.0379 (95% CI -3.98 - -0.13). There was no significant difference in FAC, RV % strain, TEI index or RVD1 with twelve weeks of CPAP therapy.

Conclusion: The present study highlights significant improvement in TAPSE and IVA with 12 weeks of CPAP treatment and no significant improvement in FAC, RVD1 and RV % strain. These data indicate favourable characteristics on both load dependent and load independent markers of RV function with CPAP.

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使用 CPAP 对阻塞性睡眠呼吸暂停患者进行干预后,右心室功能得到改善。
背景:40%-80%的心血管疾病患者存在阻塞性睡眠呼吸暂停(OSA),并对心血管健康产生不利影响。持续气道正压(CPAP)可保持睡眠时气道的通畅,并被认为可改善心脏功能。在本研究中,我们报告了 12 周 CPAP 的影响以及右心室(RV)超声心动图参数的改善情况:方法:19 名新确诊的 OSA 患者参加了研究,他们的呼吸紊乱指数 (RDI) 均大于 10。在治疗前进行超声心动图检查,并在使用 CPAP 12 周后进行随访评估。超声心动图和多普勒测量均按照美国超声心动图学会的指南进行。主要结果是等容加速度(IVA)。次要结果包括三尖瓣环面收缩期偏移(TAPSE)、分数面积变化(FAC)、RV%应变、TEI指数和RV尺寸(RVD1):等容加速度明显改善了 0.5ms2 (P = 0.0012 (95% CI -0.72, -0.20)),TAPSE明显改善了 2.05 mm (P = 0.0379 (95% CI -3.98 -0.13))。CPAP治疗12周后,FAC、RV应变%、TEI指数或RVD1无明显差异:本研究表明,CPAP 治疗 12 周后,TAPSE 和 IVA 有明显改善,而 FAC、RVD1 和 RV 百分应变无明显改善。这些数据表明,使用 CPAP 对 RV 功能的负荷依赖性和负荷独立性指标均有良好的特性。
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来源期刊
Echo Research and Practice
Echo Research and Practice CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.70
自引率
12.70%
发文量
11
审稿时长
8 weeks
期刊介绍: Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
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