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Clinical Research in Cardiology

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Open Access 01-07-2021 | Sleep Apnea | Original Paper

Automatic positive airway pressure for obstructive sleep apnea in heart failure with reduced ejection fraction

Authors: Henrik Fox, Thomas Bitter, Odile Sauzet, Volker Rudolph, Olaf Oldenburg

Published in: Clinical Research in Cardiology | Issue 7/2021

Abstract

Background

Moderate-to-severe obstructive sleep apnea (OSA) is highly prevalent in heart failure patients with reduced left ventricular ejection fraction (HFrEF), and is associated with worsening cardiac function and increased mortality.

Objectives

The automatic positive airway pressure (APAP) trial tested the impact of APAP treatment on changes for the pre-specified endpoints: changes in peak oxygen uptake (peak VO₂), percent-predicted peak VO₂ and oxygen uptake at anaerobic threshold (VO₂-AT).

Methods

This randomized, controlled pilot study included patients with chronic, stable HFrEF who had moderate-to-severe OSA. Patients were randomized 1:1 to either APAP (AutoSet™, ResMed) or nasal strips (control) for 6 months.

Results

76 patients have been randomized and 58 had complete data for final analysis. There was a statistically significant change in the APAP intervention arm for the primary endpoint percent-predicted peak VO₂ in comparison to control (67 ± 17 to 73 ± 19%; p = 0.01). Additional primary endpoints peak VO₂ and VO₂-AT showed a trend in increase in the APAP group. Moreover, there were significant improvements within the APAP group for hypoxemia, left ventricular function and quality of life from baseline to 6 months, but not within the control group (p = 0.001 and p = 0.037, respectively).

Conclusion

APAP intervention was shown to significantly improve outcome compared to control group, represented in percent-predicted peak VO₂, an established surrogate marker for cardiovascular prognosis in HFrEF. APAP has additional beneficial effects on hypoxemia, cardiac function and quality of life.

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Title: Automatic positive airway pressure for obstructive sleep apnea in heart failure with reduced ejection fraction
Authors: Henrik Fox
Thomas Bitter
Odile Sauzet
Volker Rudolph
Olaf Oldenburg
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Sleep Apnea
Heart Failure
Published in: Clinical Research in Cardiology / Issue 7/2021
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01701-1

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