title: Positive airway pressure therapy in heart failure patients: Long-term effects on lung function.
abstract: The prevalence of sleep-disordered breathing (SDB) in patients with heart failure (HF) is high. Positive airway pressure (PAP) is first-choice therapy, but recent data indicates that PAP therapy may increase mortality in HF patients with reduced ejection fraction (HF-REF) and predominant central sleep apnea (CSA). This study investigated long-term effects of PAP therapy on pulmonary function, including respiratory muscle strength. All patients underwent multichannel cardiorespiratory polysomnography (PSG) and comprehensive lung function testing at baseline and follow-up (mean 588±43days).
  
  
  
  350 patients (mean age 68±10.7years, 88% male) were included, inspiratory vital capacity, 3.3±0.9 vs 3.2±0.8L; forced expiratory volume in 1s, 2.5±0.7 vs 2.4±0.7L; lung diffusion capacity, 6.2±1.9 vs 5.9±1.8mmol/min/kPa; correction for hemoglobin, 1.1±0.02 vs 1.1±0.3mmol/min/kPa/L; and mouth occlusion pressure, 0.42±0.11 vs 0.4±0.12kPa.
  
  
  
  PAP therapy had no negative nor positive impact on lung function, including respiratory muscle strength, in stable HF-REF patients with SDB, and is therefore safe from a respiratory perspective.
authors.affiliation: Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany. Electronic address: akleemeyer@hdz-nrw.de.
authors.forename: Henrik
authors.initials: H
authors.lastname: Fox
authors.affiliation: Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Witzel
authors.affiliation: Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bitter
authors.affiliation: Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Horstkotte
authors.affiliation: Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Oldenburg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000503:physiopathology; D012189:Retrospective Studies; D013318:Stroke Volume; D014797:Vital Capacity / Q000502:physiology
keywords: Central sleep apnoea; Heart failure; Lung function; Obstructive sleep apnoea; Positive airway pressure