title: Acute effects of non-invasive ventilatory support on functional mitral regurgitation in patients with exacerbation of congestive heart failure.
abstract: 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.
authors.affiliation: Cardiopulmonary Intensive Care Unit, San Sebastiano Hospital, 42015 Correggio-Reggio Emilia, Italy. andreabellone@libero.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Bellone
authors.forename: Andrea
authors.initials: A
authors.lastname: Barbieri
authors.forename: Caterina
authors.initials: C
authors.lastname: Ricci
authors.forename: Emilio
authors.initials: E
authors.lastname: Iori
authors.forename: Mario
authors.initials: M
authors.lastname: Donateo
authors.forename: Monica
authors.initials: M
authors.lastname: Massobrio
authors.forename: Stefano
authors.initials: S
authors.lastname: Bendinelli
mesh_terms: 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