Key result
Short-term application of CPAP in CHF patients significantly reduced cardiac norepinephrine spillover (370 to 299 pmol/min; P<0.05) and cardiac output (4.8 to 4.4 L/min; P<0.05).
Why the study?
Does short-term continuous positive airway pressure (CPAP) alter hemodynamics and cardiac sympathetic activity in patients with NYHA class III congestive heart failure?
Does short-term continuous positive airway pressure (CPAP) alter hemodynamics and cardiac sympathetic activity in patients with NYHA class III congestive heart failure?
p-value: p=<0.05
Short-term CPAP acutely reduces cardiac sympathetic nervous activity in patients with NYHA class III heart failure, providing a potential mechanistic basis for its therapeutic benefit.
Short-term CPAP was associated with reduced cardiac sympathetic activity in NYHA III HF; supports mechanistic hypothesis but leaves open long-term effects.
BACKGROUND: Depressed ventricular performance and neurohormonal activation are key pathophysiological features of congestive heart failure (CHF). Although angiotensin-converting enzyme inhibitors and beta-adrenoceptor blockers exert beneficial effects in CHF, mortality remains unacceptably high, and the development of further therapeutic approaches is warranted. Recent data suggest that continuous positive airway pressure (CPAP) may be of benefit in the treatment of CHF, although the mechanism for this action is incompletely understood. METHODS AND RESULTS: In the present study, we examined the effect of short-term CPAP (10 cm H(2)O for 10 minutes) on hemodynamics (Swan Ganz catheter) and total systemic and cardiac sympathetic activity (norepinephrine spillover method) in 14 CHF patients in New York Heart Association class III. The application of CPAP was associated with a fall in cardiac output (4.8+/-0.3 to 4.4+/-0.2 L/min; P<0.05) and a significant reduction in cardiac norepinephrine spillover (370+/-58 to 299+/-55 pmol/min; P<0.05), although total systemic norepinephrine spillover was unchanged. CONCLUSION: The short-term application of CPAP results in an inhibition of cardiac sympathetic nervous activity. Further investigation into the potential value of long-term CPAP in CHF patients is warranted.
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Kaye et al. (2001) studied Congestive heart failure (n=14). Continuous positive airway pressure (CPAP) vs. Baseline was evaluated on Hemodynamics and total systemic and cardiac sympathetic activity (p=<0.05). Short-term application of CPAP in CHF patients significantly reduced cardiac norepinephrine spillover (370 to 299 pmol/min; P<0.05) and cardiac output (4.8 to 4.4 L/min; P<0.05).
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