The purpose of this study is to evaluate the long-term effects of domiciliary bilevel noninvasive positive pressure ventilation (NPPV) on sleep apnea, cardiac function, sympathetic nervous activity and heart rate variability in stable congestive heart failure.
We examined 6 patients with stable congestive heart failure who completed 1 year of domiciliary NPPV with pulsed oxymeter, chest and abdominal wall motion sensor, nasal air flow sensor and electrocardiographic monitoring system (TEIJIN, Morpheus C) during sleep at night under a room air and NPPV before (Control; C) and after 1 month (1M), 4 month (4M) and 1 year (1Y) of NPPV. Urinary noradrenaline level at night and next morning mood index were also examined. Chest rentogenogram, electrocardiography, doppler echocardiography and serum noradrenaline level were measured befor and after 1M, 4M and 1Y of domiciliary NPPV.
Apnea hypopnea index (/h) improved from 23 (C; Air) to 9 (C; NPPV), 9 (1M; NPPV), 10 (4M; NPPV) and 10 (1Y; NPPV). Centrl apnea index (/h) improved from 11 (C; Air) to 2 (C; NPPV), 2 (1M; NPPV), 3 (4M; NPPV) and 1 (1Y; NPPV). The left ventricular systolic dimension (mm) by echocardiography decreased from 50 (C) to 46 (1M), 43 (4M) and 43 (1Y). Percent fractional shortening (%) of the left ventricle increased from 21 (C) to 28 (1M), 29 (4M) and 32 (1Y), and the left ventricular ejection fraction (%) increased from 42 (C) to 51 (1M), 53 (4M) and 56 (1Y). Heart rate (bpm) decreased from 65 (C) to 59 (4M), and SDNN increased from 86 (C) to 98 (4M) and 108 (1Y). Serum noradrenaline level had decreased tendency in 1M and 1Y.
The long-term domiciliary bilevel NPPV improved a sleep apnea, cardiac function, sympathetic nervous activity, heart rate and heart rate variability in patients with stable congestive heart failure.
The long-term domiciliary bilevel NPPV might be a useful complementary therapy for stable congestive heart failure.
Hitoshi Koito, None.