Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Respiratory Research
Published in: Respiratory Research 1/2006

Open Access 01-12-2006 | Research

Effects of CPAP on right ventricular myocardial performance index in obstructive sleep apnea patients without hypertension

Authors: Nese Dursunoglu, Dursun Dursunoglu, Sibel Özkurt, Sükrü Gür, Güllü Özalp, Fatma Evyapan

Published in: Respiratory Research | Issue 1/2006

Login to get access

Abstract

Objectives

Obstructive sleep apnoea (OSA) might cause right ventricular dysfunction and pulmonary hypertension. We aimed to determine the effects of nasal continuous positive airway pressure (CPAP) therapy on right ventricular myocardial performance index (MPI) in OSA patients without hypertension.

Methods

49 subjects without hypertension, diabetes mellitus, any cardiac and pulmonary disease had overnight polysomnography and echocardiography. In 18 moderate-severe OSA (apnea-hypopnea index ≥ 15) patients, right ventricular free wall diameter (RVFWD) was measured by M-mode, and right ventricular MPI was calculated as (isovolumic contraction time+ isovolumic relaxation time) / pulmonary ejection time using Doppler at baseline and after 6 months CPAP therapy.

Results

Mean age was 46.5 ± 4.9 year. Patients had high body mass index (BMI: 30.6 ± 4,0 kg/m2), but there was no change in either BMI or blood pressures after 6 months. Right ventricular end-diastolic and end-systolic diameters were in normal limits at baseline, and did not change after CPAP usage. Baseline RVFWD (7.1 ± 2.1 mm) significantly decreased after CPAP therapy (6.2 ± 1.7 mm, p < 0.001). 15 of patients (83%) had right ventricular diastolic dysfunction at baseline, and it was completely improved in 11 of them (73%) by CPAP usage. Right ventricular global dysfunction was shown in 11 patients (61%) with a high MPI (62.2 ± 9.3%) at baseline; and MPI was significantly decreased after CPAP therapy (47.3 ± 8.4%, p < 0.0001), and it was completely corrected in 4 of them (36%).

Conclusion

CPAP therapy significantly decreases RVFWD and improves right ventricular diastolic and global functions (MPI) in OSA patients without hypertension.
Literature
1.
Dursunoglu N, Dursunoglu D: Obstructive sleep apnea syndrome, endothelial dysfunction and coronary atherosclerosis. Tuberk Toraks 2005,53(3):299–306.PubMed
2.
Dursunoglu N, Dursunoglu D: The effects of obstructive sleep apnea hypopnea syndrome on cardiovascular system. Anadolu Kardiyol Derg 2005, 5:41–5.PubMed
3.
Dursunoglu D, Dursunoglu N, Evrengül H, Özkurt S, Kuru Ö, Kılıç M, Fişekçi F: Impact of obstructive sleep apnea on left ventricular mass and global function. Eur Respir J 2005, 26:283–8.CrossRefPubMed
4.
Dursunoglu N, Dursunoglu D, Kılıç M: Impact Of Obstructive Sleep apnea on right ventricular global function: sleep apnea and myocardial performance index. Respiration 2005, 72:278–84.CrossRefPubMed
5.
Dursunoglu N, Dursunoglu D, Özkurt S, Tanriverdi H, Evrengül H, Kiter G: Severe Sleep Apnea Syndrome Diagnosed With Acute Myocardial Infarction. Asian Cardiovasc Thorac Ann 2006, in press.
6.
Guilleminault C, Connoly S, Winkle RA: Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983, 52:490–4.CrossRefPubMed
7.
Dursunoglu D, Dursunoglu N, Evrengül H, Özkurt S, Kılıç M, Fişekçi F, Kuru Ö, Delen Ö: QT interval dispersion in obstructive sleep apnea syndrome patients without hypertension. Eur Respir J 2005, 25:677–681.CrossRefPubMed
8.
Hedner J, Ejnell H, Caidahl K: Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnea. J Hypertens 1990, 8:941–6.CrossRefPubMed
9.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ: National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003, 289:2560–72.CrossRefPubMed
10.
Peker Y, Hedner J, Norum J, Kraiczi H, Carlson J: Increased Incidence of Cardiovascular Disease in Middle-aged Men with Obstructive Sleep Apnea: A 7-Year Follow-up. Am J Respir Crit Care Med 2002, 166:159–165.CrossRefPubMed
11.
Bonow RO, Udelson JE: Left ventricular diastolic dysfunction as a cause of congestive heart failure. Mechanisms and management. Ann Intern Med 1992, 117:502–10.CrossRefPubMed
12.
Petrie MC, Caruana L, Berry C, McMurray JJ: "Diastolic heart failure" or heart failure caused by subtle left ventricular systolic dysfunction? Heart 2002, 87:29–31.CrossRefPubMedPubMedCentral
13.
Naughton MT: The link between obstructive sleep apnea and heart failure: underappreciated opportunity for treatment. Curr Cardiol Rep 2005,7(3):211–5.CrossRefPubMed
14.
Sullivan CE, Issa FG, Berthon-Jones M, Eves L: Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 1981, 1:862–865.CrossRefPubMed
15.
Rapoport DM, Sorkin B, Garay SM, Goldring RM: Reversal of "pickwickian syndrome" by long term use of nocturnal airway pressure. N Engl J Med 1982, 307:931–933.CrossRefPubMed
16.
Sanders MH, Moore SE, Eveselage J: CPAP via nasal mask: a treatment for occlusive sleep apnea. Chest 1983, 83:144–145.CrossRefPubMed
17.
Dursunoglu N, Dursunoglu D, Çuhadaroğlu Ç, Kılıçaslan Z: Acute effects of automated CPAP on blood pressure in the patients with sleep apnea and hypertension. Respiration 2005, 72:150–155.CrossRefPubMed
18.
Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB: New index combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function: a study in normals and dilated cardiomyopathy. J Cardiol 1995, 26:357–66.PubMed
19.
Tei C: New non-invasive index for combined systolic and diastolic function. J Cardiol 1995, 26:396–404.
20.
Johns MW: A new method for measuring daytime sleepiness. Sleep 1991, 14:540–5.PubMed
21.
Indications for Polysomnography Task Force, American Sleep Disorders Association Standards of Practice Committee. Practice parameters for the indications for polysomnography and related proceduresSleep 1997, 20:406–22.
22.
Dingli K, Coleman EL, Vennelle M, Finch SP, Wraith PK, Machay TW, Douglas NJ: Evaluation of a portable device for diagnosing the sleep apnoea/hypopnoea syndrome. Eur Respir J 2003, 21:253–9.CrossRefPubMed
23.
American Sleep Disorders Association. The Atlas Task Force, Bonnet M, Carley D, Carskadom M, et al.: EEG arousals: scoring rules and examples. Sleep 1994, 15:173–4.
24.
American Academy of Sleep Medicine Task Force: Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 1999, 22:667–89.
25.
American Society of Echocardiography Committee on standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms, Schiller NB, Shah PM, Crawford M, et al.: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989, 2:358–367.CrossRef
26.
Berman EJ, DiBenedetto RJ, Causey DE, Mims T, Conneff M, Goodman LS, Rollings RC: Right ventricular hypertrophy detected by echocardiography in patients with newly diagnosed obstructive sleep apnea. Chest 1991, 100:347–50.CrossRefPubMed
27.
Bradley TD, Rutherford R, Grossman RF, Lue F, Zamel N, Moldofsky H, Phillipson EA: Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis 1985, 131:835–9.PubMed
28.
Weitzenblum E, Krieger J, Apprill M, Vallee E, Ehrhart M, Ratomaharo J, Oswald M, Kurtz D: Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis 1988, 138:345–9.CrossRefPubMed
29.
Chaouat A, Weitzenblum E, Krieger J, Oswald M, Kessler R: Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Results in 220 consecutive patients (see comments). Chest 1996, 109:380–6.CrossRefPubMed
30.
Bradley TD: Right and left ventricular functional impairment and sleep apnea. Clin Chest Med 1992, 13:459–79.PubMed
31.
Weiss JW, Remsburg S, Garpestad E, Ringler J, Sparrow D, Parker JA: Hemodynamic consequences of obstructive sleep apnea. Sleep 1996, 19:388–97.PubMed
32.
Sanner BM, Konermann M, Sturm A, Muller HJ, Zidek W: Right ventricular dysfunction in patients with obstructive sleep apnoea syndrome. Eur Respir J 1997, 10:2079–83.CrossRefPubMed
33.
Hanly P, Sasson Z, Zuberi N, Alderson M: Ventricular function in snorers and patients with obstructive sleep apnea. Chest 1992, 102:100–5.CrossRefPubMed
34.
Guidry UC, Mendes LA, Evans JC, Levy D, O'Connor GT, Larson MG, Gottlieb DJ, Benjamin EJ: Echocardiographic features of the right heart in sleep-disordered breathing: the Framingham Heart Study. Am J Respir Crit Care Med 2001, 164:933–8.CrossRefPubMed
35.
Bradley TD, Floras JS: Pathophysiologic and therapeutic implications of sleep apnea in congestive heart failure. J Card Fail 1996, 2:223–240.CrossRefPubMed
36.
Javaheri S: Central sleep apnea-hypopnea syndrome in heart failure: prevalence, impact and treatment. Sleep 1996, 19:229–231.
37.
Fung JW, Li TST, Choy DKL, Yip GW, Ko FW, Sanderson JE, Hui DS: Severe obstructive sleep apnea is associated with left ventricular diastolic dysfunction. Chest 2002, 121:422–429.CrossRefPubMed
38.
Arabi Y, Morgan BJ, Goodman B, Puleo DS, Xie A, Skatrud JB: Daytime blood pressure elevation after nocturnal hypoxia. J Appl Physiol 1999, 87:689–98.PubMed
39.
Cloward TV, Walker JM, Farney RJ, Anderson JL: Left ventricular hypertrophy is a common echocardiographic abnormality in severe obstructive sleep apnea and reverses with nasal continuous positive airway pressure. Chest 2003,124(2):594–601.CrossRefPubMed
40.
Dimsdale JE, Loredo JS, Profant J: Effect of continuous positive airway pressure on blood pressure: a placebo trial. Hypertension 2000, 35:144–7.CrossRefPubMed
41.
Faccenda JF, Mackay TW, Boon NA, et al.: Randomized placebo-controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea-hypopnea syndrome. Am J Respir Crit Care Med 2002,163(2):344–8.CrossRef
42.
Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH: Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003,107(1):68–73.CrossRefPubMed
43.
Doherty LS, Kiely JL, Swan V, McNicholas WT: Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005,127(6):2076–84.CrossRefPubMed
Metadata
Title
Effects of CPAP on right ventricular myocardial performance index in obstructive sleep apnea patients without hypertension
Authors
Nese Dursunoglu
Dursun Dursunoglu
Sibel Özkurt
Sükrü Gür
Güllü Özalp
Fatma Evyapan
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2006
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-7-22

Other articles of this Issue 1/2006

Respiratory Research 1/2006 Go to the issue

Research

Participation of the PI-3K/Akt-NF-κB signaling pathways in hypoxia-induced mitogenic factor-stimulated Flk-1 expression in endothelial cells

Research

Determinants of mortality for adults with cystic fibrosis admitted in Intensive Care Unit: a multicenter study

Research

An experimental model of rhinovirus induced chronic obstructive pulmonary disease exacerbations: a pilot study

Research

Reference values for exhaled nitric oxide (reveno) study

Research

Arginase strongly impairs neuronal nitric oxide-mediated airway smooth muscle relaxation in allergic asthma

Research

Spinal afferent neurons projecting to the rat lung and pleura express acid sensitive channels
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits