Effect of nasal continuous positive airway pressure on patients with chronic heart failure due to hypertensive heart disease complicated with severe obstructive sleep apnea hypopnea syndrome

Abstract

Objective To investigate the clinical efficiency of nasal continuous positive airway pressure (nCPAP) on patients with chronic heart failure(CHF) due to hypertensive heart disease complicated with severe obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty cases with CHF due to hypertensive heart disease complicated with severe OSAHS were divided into treatment group and control group with 25 cases each by the method of random digits table.nCPAP and routine drug treatment were administered in treatment group,while only routine drug treatment was given in control group.Cardiac functional grading,blood pressure,left ventricular end diastolic dimension (LVDd),left ventricular ejection fraction (LVEF),B-type natriuretic peptide (BNP),high-sensitivity C-reactive protein (hs-CRP) were compared before and after 3-month therapy.Results The effective rate in treatment group was significantly higher than that in control group [76.00％(19/25) vs.40.00％(10/25)],and there was significant difference (P ＜0.05).There was significantly decreased in blood pressure in two groups at the end of the therapy [treatment group:(127.52 ± 10.38)/(72.44 ±4.92) mmHg(1 mmHg =0.133 kPa) vs.(176.80 ± 12.90)/ (100.44 ±5.55) mmHg;control group:(150.12 ± 18.96)/ (81.64 ±9.42) mmHg vs.(176.00 ± 11.69)/ (96.08 ± 18.59) mmHg] (P ＜ 0.01),but the blood pressure was significantly lower in treatment group than that in control group (P ＜0.05).LVDd,BNP and hs-CRP in treatment group was declined significantly [(49.12 ± 3.18) mm vs.(57.44 ± 3.62) mm,525.52 ng/L vs.785.25 ng/L,(7.76 ± 1.69) mg/L vs.(18.04 ± 2.58) mg/L](P＜ 0.01);LVEF was significantly increased [(46.12 ± 2.52)％ vs.(38.68 ± 4.65)％](P＜ 0.01).There was no significant difference in LVDd and LVEF in control group before and after therapy (P ＞ 0.05).BNP and hs-CRP also were declined significantly [668.66 ng/L vs.850.96 ng/L,(12.88 ± 2.02) mg/L vs.(19.40 ± 2.30) mg/L] (P ＜ 0.05 or ＜ 0.01),but the above two were significantly lower in treatment group than those in control group(P ＜ 0.05).Conclusion nCPAP therapy can effectively improve the symptoms of heart failure,decrease blood pressure,improve cardiac function,reduce the inflammation response to patients with CHF due to hypertensive heart disease complicated with severe OSAHS. Key words: Continuous positive airway pressure; Heart failure; Sleep apnea,obstructive; Hypertensive heart disease