Continuous Positive Airway Pressure Therapy Reduces Right Ventricular Volume in Patients with Obstructive Sleep Apnea: A Cardiovascular Magnetic Resonance Study

Magalang, Ulysses J.; Richards, Kathryn E.; McCarthy, Beth; Fathala, Ahmed; Khan, M. Gabriel; Parinandi, Narasimham L.; Raman, Subha V.

doi:10.5664/jcsm.27437

Cited by 24 publications

(13 citation statements)

References 31 publications

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“…In OSAS patients undergoing three‐dimensional echocardiography, Oliveira et al showed a reduction in pulmonary vascular resistance and an increase in RV ejection fraction (63.0 ± 7.2 to 70.8 ± 0.9%) after 24 weeks of NIV treatment . Finally, using cardiac magnetic resonance, Magalang et al reported that CPAP therapy decreased RV volumes in patients with severe OSAS …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…35 Finally, using cardiac magnetic resonance, Magalang et al reported that CPAP therapy decreased RV volumes in patients with severe OSAS. 36…”

Section: Acute and Chronic Effects Of Continuous Positive Airway Presmentioning

confidence: 99%

Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study

et al. 2016

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“…34 In patients with OSA, as assessed by cardiac magnetic resonance imaging, nCPAP improved right ventricular end diastolic and systolic volumes without an appreciable change in left ventricular size or function. 35 nCPAP has also been shown to reduce arterial stiffness, mean peripheral arterial pressure and central blood pressure in patients with newly diagnosed OSA, and a deterioration in these parameters was seen following nCPAP withdrawal. 36 We examined oxygen pulse during exercise as a surrogate of stroke volume, and mean arterial pressure during exercise.…”

Section: Discussionmentioning

confidence: 99%

CPAP increases exercise tolerance in obese subjects with obstructive sleep apnea

Pendharkar

Tsai

Eves

et al. 2011

Respiratory Medicine

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Obese subjects commonly suffer from exertional dyspnea and exercise intolerance. Preliminary evidence suggests that treatment with nocturnal continuous positive airway pressure (nCPAP) may improve dyspnea in obese patients with obstructive sleep apnea (OSA), but the effect on exercise tolerance is unknown. This study sought to investigate whether nCPAP improves exercise tolerance and exertional dyspnea in obese patients with OSA. Obese patients prescribed nCPAP for moderate/severe OSA and without cardiopulmonary disease were recruited. Patients completed a constant-load exercise test and Baseline and Transitional Dyspnea Index questionnaires (BDI/TDI) at baseline and after one and three months of nCPAP. Primary outcome was change in constant-load exercise time from baseline to one and three months. Secondary outcomes included changes in isotime dyspnea, isotime leg fatigue and BDI/TDI score at one and three months. Fifteen subjects (body mass index = 43 kg m(-2), apnea-hypopnea index = 49(.)hr(-1)) were studied. Constant-load exercise time increased by 2.0 min (40%, p = 0.02) at one month and 1.8 min (36%, p = 0.04) at three months. At one and three months, isotime dyspnea decreased by 1.4 (p = 0.17) and 2 units (p = 0.04), and leg fatigue decreased by 1.2 (p = 0.18) and 2 units (p = 0.02), respectively. BDI/TDI scores were 2.7 (p = 0.001) and 4.5 points (p< 0.001) at one and three months. Peak oxygen consumption and static pulmonary function were unchanged. Nocturnal CPAP improves exercise tolerance and dyspnea in obese patients with OSA. Effects on exercise time and chronic dyspnea were seen after one and three months of nCPAP, while exertional dyspnea was only improved at three months.

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“…Researches that CPAP can improve LV and RV function indicate the most direct evidence that OSAS causes cardiovascular abnormalities 12 , 56 . Magalang et al reported that the end-diastolic volume of RV decreased significantly in OSAS patients who received CPAP treatment for 3 months 57 . In our study, after > 6 months treatment with CPAP, RV morphology and function had significantly improved, including decreased RA and RV volumes, increased RV ejection fraction and improved RV strains, which indicated a physiopathologic association between RV performance and OSAS.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular performance and impact of continuous positive airway pressure therapy in patients with obstructive sleep apnea living at high altitude

Chu

Yang

et al. 2020

Sci Rep

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Obstructive sleep apnea syndrome (OSAS) can lead to alterations in right ventricular (RV) performance and pulmonary vascular haemodynamics. Additionally, altitude-related hypoxia is associated with pulmonary vasoconstriction, and the effect of high-altitude on the pulmonary circulation in OSAS patients can be further altered. We sought to assess alterations in RV morphology and function in OSAS patients living at high altitude by way of 2-dimensional speckle tracking echocardiography (2D-STE), real-time 3- dimensional echocardiography (RT-3DE) and cardiac biomarkers. We also evaluate the impact of continuous positive airway pressure (CPAP) treatment on RV performance. Seventy-one patients with newly diagnosed OSAS and thirty-one controls were included in this study. All individuals were assessed for cardiac biomarkers as well as underwent 2D-STE and RT-3DE. Forty-five OSAS patients underwent CPAP therapy for at least 24 weeks and were studied before and after CPAP treatment. RT-3DE was used to measure RV volume, and calculate RV 3D ejection fraction (3D RVEF). Peak systolic strain was determined. Cardiac biomarkers, including C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide, and cardiac troponin T were also measured. Right atrium volume index, RV volume, RV volume index, systolic pulmonary artery pressure (sPAP), pulmonary vascular resistance (PVR) and level of serum CRP were significantly higher in OSAS group, while OSAS patients showed lower 3D RVEF and RV longitudinal strains. Compared to the patients with sPAP < 40 mmHg, RV longitudinal strains in patients with sPAP ≥ 40 mmHg were lower. Both RV global longitudinal strain and sPAP were associated with apnea–hypopnea index. Patients treated with 6 months of CPAP therapy had significant improvement in RV geometry and performance. RV structural abnormalities and RV function impairments were observed in OSAS patients living at moderate high altitude compared to control highlanders. The reversibility of these changes after application of CPAP were further confirmed.

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Continuous Positive Airway Pressure Therapy Reduces Right Ventricular Volume in Patients with Obstructive Sleep Apnea: A Cardiovascular Magnetic Resonance Study

Cited by 24 publications

References 31 publications

Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study

Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study

CPAP increases exercise tolerance in obese subjects with obstructive sleep apnea

Evaluation of right ventricular performance and impact of continuous positive airway pressure therapy in patients with obstructive sleep apnea living at high altitude

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