Key result
Positive airway pressure consistently improves LVEF, AHI, and quality of life in HF patients with OSA.
Why the study?
Heart failure patients commonly experience obstructive sleep apnea, which may worsen their condition, prompting an investigation into OSA prevalence, PAP treatment effects, and HF pharmacotherapy impacts.
Do positive airway pressure (PAP) treatment and HF pharmacotherapies (SGLT2i, sacubitril/valsartan) improve OSA outcomes and HF parameters in adult patients with heart failure?
Systematic Review
Do positive airway pressure (PAP) treatment and HF pharmacotherapies (SGLT2i, sacubitril/valsartan) improve OSA outcomes and HF parameters in adult patients with heart failure?
PAP treatment and emerging HF pharmacotherapies like SGLT2i and sacubitril/valsartan show promise in improving OSA symptoms and HF parameters in patients with concurrent heart failure and obstructive sleep apnea.
Supports PAP as adjunctive therapy in HF with OSA; reinforces consensus on integrated sleep-cardiac management.
BACKGROUND: Heart failure (HF) patients commonly experience obstructive sleep apnea (OSA), which may worsen their condition. We reviewed a diverse range of studies to investigate the prevalence of OSA in HF patients, the effects of positive airway pressure (PAP) treatment, and the potential impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and sacubitril/valsartan on OSA outcomes. METHODS: We analyzed case-control, observational studies, and randomized controlled trials. Prevalence rates, PAP treatment, and HF pharmacotherapy were assessed. RESULTS: Numerous studies revealed a high prevalence of OSA in HF patients, particularly with preserved ejection fraction. PAP treatment consistently improved an apnea-hypopnea index, left ventricular ejection fraction, oxygen saturation, and overall quality of life. Emerging evidence suggests that SGLT2i and sacubitril/valsartan might influence OSA outcomes through weight loss, improved metabolic profiles, and potential direct effects on upper airway muscles. CONCLUSIONS: The complex interplay between OSA and HF necessitates a multifaceted approach. PAP treatment has shown promising results in improving OSA symptoms and HF parameters. Additionally, recent investigations into the effects of HF pharmacotherapy on OSA suggest their potential as adjunctive therapy. This review provides insights for clinicians and researchers, highlighting the importance of addressing OSA and HF in patient management strategies.
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Polecka et al. (2023) conducted a systematic review in Heart failure and obstructive sleep apnea. Positive airway pressure (PAP) and heart failure pharmacotherapy (SGLT2i, sacubitril/valsartan) was evaluated on Prevalence of OSA and effects on apnea-hypopnea index, left ventricular ejection fraction, oxygen saturation, and quality of life. Positive airway pressure treatment consistently improved the apnea-hypopnea index, left ventricular ejection fraction, oxygen saturation, and quality of life in heart failure patients with OSA.
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