Noninvasive ventilation improves cardiac function in patients with chronic heart failure

// Jing Cheng 1 , Yanping Liu 1,2 , Guishuang Li 1 , Zhongwen Zhang 3 , Lianyue Ma 1 , Xiaoyan Yang 1 , Jianmin Yang 1 , Kai Zhang 1 , Jing Kong 1 , Mei Dong 1 , Meng Zhang 1 , Xingli Xu 1 , Wenhai Sui 1 , Jiali Wang 1 , Rui Shang 1 , Xiaoping Ji 1 , Yun Zhang 1 , Cheng Zhang 1 and Panpan Hao 1 1 The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, China 2 Shandong Key Laboratory of Cardiovascular and Cerebrovascular Disease, Shandong Provincial Medical Imaging Institute, Shandong University, Jinan, Shandong, China 3 Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China Correspondence to: Panpan Hao, email: // Keywords : noninvasive ventilation, chronic heart failure, sleep-disordered breathing, left ventricular ejection fraction, brain natriuretic peptide, Pathology Section Received : April 15, 2016 Accepted : June 17, 2016 Published : July 06, 2016 Abstract Chronic heart failure (CHF) has been shown to be associated with an increased incidence of sleep-disordered breathing. Whether treatment with noninvasivepositive-pressure ventilation (NPPV), including continuous positive airway pressure, bi-level positive airway pressure and adaptive servo-ventilation, improves clinical outcomes of CHF patients is still debated. 2,832 CHF patients were enrolled in our analysis. NPPV was significantly associated with improvement in left ventricular ejection fraction (39.39% vs. 34.24%; WMD, 5.06; 95% CI, 3.30-6.81; P < 0.00001) and plasma brain natriuretic peptide level (268.23 pg/ml vs. 455.55 pg/ml; WMD, -105.66; 95% CI, [-169.19]-[-42.13]; P = 0.001). However, NPPV did not reduce all-cause mortality (0.26% vs. 0.24%; OR, 1.13; 95% CI, 0.93-1.37; P = 0.22) or re-hospitalization rate (57.86% vs. 59.38%; OR, 0.47; 95% CI, 0.19-1.19; P = 0.02) as compared with conventional therapy. Despite no benefits on hard endpoints, NPPV may improve cardiac function of CHF patients. These data highlight the important role of NPPV in the therapy of CHF.