title: Cardiac structure and function improvements in coronary artery disease combined with severe obstructive sleep apnea/hypopnea syndrome patients via noninvasive positive pressure ventilation therapy.
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of a noninvasive positive pressure ventilation therapy on cardiac structure and function in patients with coronary heart disease combined with obstructive sleep apnea/hypopnea syndrome (OSAHS).
  
  
  METHODS
  Eighty patients with coronary heart disease OSAHS were divided randomly into treatment (n=40) and control (n=40) groups. Both groups received standard medications. The treatment group received additional noninvasive mechanical ventilation support for at least 3 h (3-6 h) every night. On the first day after selection and 3 months afterwards, participants were examined with echocardiograms, 24-h ambulatory blood pressure monitoring, and blood analyses. Primary endpoints were left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left atrial diameter as well as serum concentrations of N-terminal prohormone of brain natriuretic peptide, and high-sensitive C-reactive protein. Secondary endpoints included cardiac death, nonfatal myocardial infarction, and hospitalization.
  
  
  RESULTS
  After the 3-month study period, patients in the treatment group showed significantly improved left ventricular end-diastolic diameter (P=0.02), left ventricular end-systolic diameter (P=0.035), left ventricular ejection fraction (P=0.05), and left atrial diameter (P=0.02) values, and their serum N-terminal prohormone of brain natriuretic peptide (P=0.01) and high-sensitive C-reactive protein (P=0.04) concentrations were significantly improved compared with the control group. During the 3 months, three cardiovascular complications occurred in the treatment group versus nine in the control group (P<0.05).
  
  
  CONCLUSIONS
  For patients with coronary heart disease combined with OSAHS, noninvasive mechanical ventilation therapy can significantly improve heart functions and reduce the occurrence of cardiovascular complications.
authors.affiliation: aDepartment of Cardiology, Shanghai Shi Dong Hospital bDepartment of Geriatrics, Shanghai No. 3 People's Hospital cDepartment of Cardiology, An Tu Hospital, Shanghai, China.
authors.forename: Xinbing
authors.initials: X
authors.lastname: Liu
authors.forename: Liuliu
authors.initials: L
authors.lastname: Feng
authors.forename: Guoliang
authors.initials: G
authors.lastname: Cao
authors.forename: Hongman
authors.initials: H
authors.lastname: Huang
authors.forename: Qitan
authors.initials: Q
authors.lastname: Xu
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yu
authors.forename: Shufu
authors.initials: S
authors.lastname: Zhang
authors.forename: Mingcheng
authors.initials: M
authors.lastname: Zhou
mesh_terms: D000368:Aged; D064752:Atrial Remodeling / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002681:China; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D063087:Noninvasive Ventilation; D010446:Peptide Fragments / Q000097:blood; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D020127:Recovery of Function; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein