Acute effects of non-invasive ventilatory support on functional mitral regurgitation in patients with exacerbation of congestive heart failure.
OBJECTIVE
The purpose of this study was to evaluate the acute effects of continuous positive airway pressure (CPAP) and bi-level airway pressure (BiPAP) on functional mitral regurgitation (MR) in patients with acute exacerbation of severe chronic congestive heart failure (CHF).


METHODS
A cross-over study.


METHODS
A cardiopulmonary intensive care unit.


METHODS
Ten male patients affected by an acute exacerbation of congestive heart failure and hemodynamically significant MR were submitted to an echocardiograph color Doppler ultrasound evaluation during CPAP and BiPAP non-invasive ventilation. We analyzed left ventricle ejection fraction, area of MR and deceleration time (Dec-t).


METHODS
The primary end point was to evaluate whether CPAP and BiPAP were effective in reducing functional MR.


RESULTS
After 30 min, the area of MR decreased from 10.0+/-2.7 to 8.0+/-2.9 cm(2) with CPAP and from 9.9+/-2.6 to 8.6+/-2.6 cm(2) with BiPAP ( p<0.01); Dec-t increased from 120.9+/-12.7 to 136.0+/-8.7 ms after CPAP and from 120.5+/-11.4 to 134.2+/-13.6 ms after BiPAP ( p<0.01).


CONCLUSIONS
In patients with exacerbation of severe CHF and functional MR, both modalities of non-invasive ventilation (CPAP and BiPAP) significantly improved ejection fraction and were equally effective in reducing MR.
Bellone
Andrea
A
Cardiopulmonary Intensive Care Unit, San Sebastiano Hospital, 42015 Correggio-Reggio Emilia, Italy. andreabellone@libero.it
Barbieri
Andrea
A
Ricci
Caterina
C
Iori
Emilio
E
Donateo
Mario
M
Massobrio
Monica
M
Bendinelli
Stefano
S
D000368:Aged; D018592:Cross-Over Studies; D004452:Echocardiography; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology*; D011175:Positive-Pressure Respiration