title: Efficacy of positive airway pressure on brain natriuretic peptide in patients with heart failure and sleep-disorder breathing: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Positive airway pressure (PAP) has been recognized as an effective therapeutic option for sleep-disordered breathing (SDB) in patients with heart failure (HF), and it can improve left ventricular function. Whether PAP can ameliorate serum brain natriuretic peptide (BNP) levels, a biomarker of HF, is controversial. The purpose of the present study was to quantitatively assess the efficacy of PAP on BNP in patients with HF and SDB.
  
  
  METHODS
  A systematic search of PubMed, Embase, Web of Science and Cochrane library identified six randomized controlled trials (RCTs), in which PAP was compared with medical therapy, subtherapeutic PAP or different types of PAP. The data of BNP were extracted and pooled into meta-analysis using STATA 12.0.
  
  
  RESULTS
  Totally 6 RCT studies (7 cohorts) with 222 patients were enrolled into analysis. The quality of each study was high and the heterogeneity (I(2) = 58.1%) was noted between studies. A significant reduction of BNP was observed after PAP treatment in patients with HF and SDB (SMD -0.517, 95% CI -0.764 to -0.270, z = 4.11, p = 0.000).
  
  
  CONCLUSIONS
  Our meta-analysis of RCTs demonstrated that PAP elicits significant reduction of BNP in patients with HF and SDB.
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, 361004, Fujian, China, zhangxiaobincn@126.com.
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Zhang
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Yuan
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Du
authors.forename: Xing-Tang
authors.initials: XT
authors.lastname: Jiang
authors.forename: Hui-Qing
authors.initials: HQ
authors.lastname: Zeng
mesh_terms: D045422:Continuous Positive Airway Pressure; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000628:therapy*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016032:Randomized Controlled Trials as Topic; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications / Q000628:therapy*
chemical_list: D020097:Natriuretic Peptide, Brain