title: Noninvasive Positive Pressure Ventilation in Chronic Heart Failure.
abstract: Instruction and Objectives. Noninvasive positive pressure ventilation (NPPV) alleviates sleep-disordered breathing (SDB) and it may improve cardiac function in SDB patients. Because large randomized controlled trials directly evaluating the impact of NPPV on cardiac function are lacking, we conducted a meta-analysis of published data on effectiveness of NPPV in improving cardiac function in patients with chronic heart failure regardless of SDB presence.Methods. Controlled trials were identified in PubMed, OVID, and EMBASE databases. Both fixed and randomized models were used in meta-analysis with primary outcomes of left ventricular ejection fraction (LVEF).Results. Nineteen studies were included with a total of 843 patients. Compared to standard medical treatment (SMT) plus sham-NPPV or SMT only, NPPV plus SMT was associated with improvement in LVEF (weighted mean difference 5.34, 95% CI, [3.85,6.82];P< 0.00001) and plasma brain natriuretic peptide (BNP) level (weighted mean difference -117.37, 95% CI, [-227.22, -7.52];P= 0.04) and no influence on overall mortality (RR 1.00, 95% CI, [0.96,1.04];P= 0.95).Conclusions. In the present meta-analysis, use of NPPV plus SMT improved LVEF and reduced plasma BNP level but did not improve overall mortality in patients with chronic heart failure.
authors.affiliation: Department of Cardiovascular Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Hao
authors.identifier: 0000-0001-6888-7742
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Cardiovascular Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Renal Division and Molecular Cell Laboratory for Kidney Disease, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Chenqi
authors.identifier: 0000-0003-1496-0937
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Cardiovascular Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jun
authors.identifier: 0000-0003-2240-5108
authors.initials: J
authors.lastname: Pu
authors.affiliation: Department of Cardiovascular Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Ben
authors.identifier: 0000-0001-7461-5188
authors.initials: B
authors.lastname: He
mesh_terms: D002908:Chronic Disease; D006333:Heart Failure / Q000097:blood / Q000401:mortality / Q000628:therapy*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011175:Positive-Pressure Respiration; D013318:Stroke Volume
chemical_list: D020097:Natriuretic Peptide, Brain