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[Modification of cardiopulmonary performance parameters in patients with obstructive sleep apnea treated with nCPAP
M Konermann1, B Sanner, J Klewer
1Medizinischen Universitätsklinik, Ruhr-Universität Bochum, Marten-hospital Herne, Deutschland.
Abstract:
nCPAP influences cardiopulmonary hemodynamic function in patients with obstructive sleep apnea (OSA). It is known that systolic function of the right and left ventricle, systemic and pulmonary hypertension, arterial blood gases and lung function during the day may improve under this treatment. We prospectively followed 30 patients with severe OSA and determined diastolic left ventricular function (Doppler echocardiography), cardiovascular efficiency (steady state exercise stress testing); and individual assessment of performance (standardized psychometric questionnaire) before, and 2 weeks and 6 months after initiation of nCPAP treatment. The following results could be obtained (first value after 2 weeks, second value after 6 months): Doppler echocardiography: E/A rose by 9.3% (p < 0.05) and another 0.5% (n.s.). E/A integral increased by 13.8% (p < 0.01) and another 3.5% (n.s.). Deceleration period decreased by 22.7% (p < 0.01) and another 3.1% (n.s.). Steady state exercise stress testing: Maximum performance rose by 10% (p < 0.05) and another 17.5% (p < 0.01). Heart rate ratio 100 W/rest dropped by 13.5% (p < 0.001) and another 6.5% (p < 0.01), systolic blood pressure ratio 100 W/rest by 0.8% (n.s.) and another 14.9% (p < 0.001). Diastolic blood pressure ratio 100 W/rest did not change significantly. Questionnaire: Assessment of well-being increased by 44.5% (p < 0.05) and another 16.9% (n.s.). After an initial drop of 0.8% (n.s.), quality of life increased by 14.9% (p < 0.05). Assessment of performance rose by 21.7% (p < 0.05) and another 4.1% (n.s.). nCPAP therapy in patients with OSA improves diastolic function of the left ventricle, cardiovascular performance and individual assessment of performance.