Abstract: Poster Presentations |

Effects of One Month of Domiciliary Noninvasive Positive Pressure Ventilation on Sleep Apnea and Cardiac Function in Stable Congestive Heart Failure FREE TO VIEW

Hitoshi Koito, MD; Keiko Kohno, MD; Katsuya Maruyama, MD; Satoshi Morita, MD; Hiroshi Yutaka, MD
Author and Funding Information

Kansai Medical University, Otokoyama Hospital, Yawata, Kyoto, Japan


Chest. 2003;124(4_MeetingAbstracts):187S. doi:10.1378/chest.124.4_MeetingAbstracts.187S-a
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PURPOSE:  To evaluate the effects of one month of domiciliary noninvasive positive pressure ventilation (NIPPV) on sleep apnea (SA), cardiac function and sympathetic nervous activity in stable congestive heart failure (CHF).

METHODS:  The subjects were 7 patients (pts) with stable CHF (5; dilated cardiomyopathy, 2; old myocardial infarction). These pts were divided into 2 groups (central apnea index (CAI) ≥15 (CSA group) and CAI<15 (OSA group)) and examined with SpO2, chest and abdominal motion, nasal air flow and ECG monitoring system (Morpheus C; Teijin), urinary noradrenaline and next morning mood during sleep at night under room air (Control) and NIPPV before and after one month of domiciliary NIPPV. Echo-Doppler cardiography, respiratory function, serum norepinephrine, Epworth sleepiness scale (ESS) were also evaluated before and after one month of NIPPV.

RESULTS:  Apnea hypopnea index (AHI; /hr) improved significantly from 26±10 (Before, air) to 13±10 (Before, NIPPV), 11±8 (After, NIPPV) and 21±11 (After, air). After one month AHI decreased even without NIPPV, whichi was due to improvement of OSA. CAI improved from 12±10 (Before, air) to 2±2 (Before, NIPPV) and 4±6 (After, NIPPV). CAI in after, air did not change (11±10) and CSA contributed to this. Next morning mood improved only in after, air. LVEF (%) and %FS (%) after one month of NIPPV increased from 22±6 to 28±4 and 43±10 to 52±6, respectively. Systolic LV dimension (LVDs;mm), systolic RV pressure (RVsP;mmHg), s-noradrenaline and ESS after one month of NIPPV decreased from 49±4 to 45±5, 42±5 to 35±9, 0.48±0.28 and 12±6 to 8±6, respectively. CSA contributed to improvement of LVDs and RVsP, and OSA contributed to improvement of LVDs, %FS and LVEF. No significant change was seen in LA dimension, diastolic LV dimesion, respilatory function or u-noradrenaline.CONCLUSIONS: One month of domiciliary NIPPV is an effective therapy in imprving SA, day time sleepiness, cardiac function and sympathetic nervous activity in stable CHF.

CLINICAL IMPLICATIONS:  One month of domiciliary NIPPV is a useful complimentary therapy for treating stable CHF.

DISCLOSURE:  H. Koito, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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