Continuous positive airway pressure significantly improved left ventricular global longitudinal strain (MD -1.92%; 95% CI -2.63 to -1.21; P<0.01) and right ventricular global longitudinal strain.
Meta-Analysis (n=385)
Does continuous positive airway pressure (CPAP) improve myocardial strain and remodeling in patients with obstructive sleep apnea?
CPAP therapy significantly improves both left and right ventricular global longitudinal strain and reduces right atrial volume and pulmonary artery systolic pressure in patients with obstructive sleep apnea.
Effect estimate: MD -1.92% (95% CI -2.63 to -1.21)
p-value: p=< 0.01
Obstructive sleep apnea (OSA) is associated with structural heart disease, with continuous positive airway pressure (CPAP) potentially improving cardiac remodeling. This meta-analysis provides an updated assessment of CPAP's effects on myocardial strain and remodeling in patients with OSA. A systematic review and meta-analysis of clinical studies evaluating CPAP's effects on speckle-tracking echocardiographic parameters in OSA patients was conducted. PubMed, Embase and Cochrane Central were searched. A random-effects model analyzed pooled data. Studies assessing right ventricular global longitudinal strain (RV-GLS) or left ventricular global longitudinal strain (LV-GLS) were included. Ten studies one randomized controlled trial (RCT), nine observational involving 385 patients treated with CPAP were analyzed. CPAP significantly improved left ventricular GLS -1.92% -2.63 to -1.21 (MD 95% confidence interval), P < 0.01; and right ventricular GLS -1.88% -2.77 to -0.99, P < 0.01. No significant changes were observed in LVEF 0.77% -0.65 to 2.18 P = 0.29; TAPSE 0.07 mm -0.53 to 0.68 P = 0.81, I 2 = 0%; LV mass SMD -0.22; -0.56 to 0.12 P = 0.54, I 2 = 0%; PVR -0.59 -1.25 to 0.04 P = 0.08; or E/e’ ratio -0.95 -2.42 to 0.53, P = 0.21. CPAP significantly reduced PASP –5.23 mmHg -8.54 to -1.92, P = 0.002, I 2 = 64%; and right atrial volume index -3.96 ml/m 2 -5.43 to -2.50, P < 0.001, with no significant change in left atrial volume SMD -0.01; -0.35 to 0.32, P = 0.93. CPAP therapy improves both left and right ventricular function and reduces right atrial volume in patients with OSA. Further trials are needed to assess CPAP's long-term impact on myocardial strain and cardiac mechanics beyond conventional echocardiography.
Castro et al. (Fri,) conducted a meta-analysis in obstructive sleep apnea (n=385). continuous positive airway pressure (CPAP) was evaluated on left ventricular global longitudinal strain (LV-GLS) (MD -1.92%, 95% CI -2.63 to -1.21, p=< 0.01). Continuous positive airway pressure significantly improved left ventricular global longitudinal strain (MD -1.92%; 95% CI -2.63 to -1.21; P<0.01) and right ventricular global longitudinal strain.