Kardiale Funktion bei Patienten mit obstruktivem Schlafapnoesyndrom und behandelter arterieller Hypertonie : Vorteile durch CPAP-Therapie?

Background and Purpose: 30% of patients with arterial hypertension (AH) are supposed to have a coprevalent obstructive sleep apnea syndrome (OSAS). Hence, the influence of CPAP (continuous positive airway pressure) therapy on cardiac structure and function was investigated in medically treated patients with AH and coprevalent OSAS. Patients and Methods: In all patients AH was treated for at least 5 years. Matched pairs concerning anthropometric data, medical therapy and duration of AH, and severity of OSAS were investigated: 20 patients with untreated OSAS were compared to 20 patients with CPAP therapy for at least 6 months. Further cardiopulmonary diseases were excluded. Cardiac structure and function were assessed echocardiographically. Results: Patients under CPAP therapy had significantly better diastolic left ventricular function, a lower left ventricular mass index, and significantly less frequent signs of left ventricular (eccentric) hypertrophy than patients with untreated OSAS. Furthermore, differences were significant concerning right ventricular wall thickness and mean pulmonary artery pressure. Conclusion: CPAP therapy positively influences left and right cardial structure and function in addition to antihypertensive medication in patients with AH and coprevalent OSAS.