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Article: Alleviation of pulmonary hypertension by cardiac resynchronization therapy is associated with improvement in central sleep apnea

TitleAlleviation of pulmonary hypertension by cardiac resynchronization therapy is associated with improvement in central sleep apnea
Authors
Issue Date2008
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2008, v. 31 n. 12, p. 1522-1527 How to Cite?
AbstractBackground: Recent studies have demonstrated that cardiac resynchronization therapy (CRT) reduces sleep apnea in heart failure (HF); however, the mechanism of benefit remains unclear. Methods: Overnight polysomnography (PSG) was performed in consecutive HF patients who were scheduled for CRT implant. Patients with sleep apnea defined by an apnea-hypopnea index (AHI) of >10/hour were recruited and underwent echocardiogram examination at baseline and 3 months after CRT. Results: Among 37 HF patients screened, 20 patients (54%) had sleep apnea and 15 of them consented for the study. After 3 months of CRT, there was a significant improvement in New York Heart Association functional class (3.1 ± 0.1 vs 2.1 ± 0.1, P < 0.01), quality-of-life (QoL) score (62.9 ± 3.3 vs 56.1 ± 4.5, P = 0.02), left ventricular ejection fraction (LVEF, 28.8 ± 2.5% vs 38.1 ± 2.3%, P < 0.01), and reduction in pulmonary artery systolic pressure (PASP, 41.0 ± 2.7 vs 28.6 ± 2.2 mmHg; P < 0.01) compared with baseline. Repeated PSG after CRT demonstrated a reduction in the duration of arterial oxygen desaturation ≤95% (251.2 ± 36.7 vs 141.0 ± 37.1 minutes), AHI (27.5 ± 4.7 vs 18.1 ± 3.0, P = 0.05), and number of central sleep apnea (CSA) (7.8 ± 2.6 vs 3.0 ± 1.3/hour, P = 0.03), but not number of obstructive sleep apnea (OSA, 8.6 ± 3.3 vs 7.2 ± 2.3/hour, P = 0.65) compared to baseline. Percentage change in PASP was significantly correlated with percentage changes in LVEF (r = -0.57, P = 0.04), AHI (r = 0.5, P = 0.05), and number of CSA episodes (r = 0.55, P = 0.02). Conclusions: The results demonstrated that CRT significantly reduces CSA in patients with HF. Importantly, we have noted a decrement of PASP correlated to drop in CSA which maybe one of the mechanisms explaining this observation. Future studies are required to confirm our finding and elucidate other possible mechanisms in this regard. © 2008, The Authors.
Persistent Identifierhttp://hdl.handle.net/10722/163210
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYiu, KHen_US
dc.contributor.authorLee, KLFen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorSiu, CWen_US
dc.contributor.authorMiu, KMen_US
dc.contributor.authorLam, Ben_US
dc.contributor.authorLam, Jen_US
dc.contributor.authorIp, MSMen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2012-09-05T05:28:46Z-
dc.date.available2012-09-05T05:28:46Z-
dc.date.issued2008en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2008, v. 31 n. 12, p. 1522-1527en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/163210-
dc.description.abstractBackground: Recent studies have demonstrated that cardiac resynchronization therapy (CRT) reduces sleep apnea in heart failure (HF); however, the mechanism of benefit remains unclear. Methods: Overnight polysomnography (PSG) was performed in consecutive HF patients who were scheduled for CRT implant. Patients with sleep apnea defined by an apnea-hypopnea index (AHI) of >10/hour were recruited and underwent echocardiogram examination at baseline and 3 months after CRT. Results: Among 37 HF patients screened, 20 patients (54%) had sleep apnea and 15 of them consented for the study. After 3 months of CRT, there was a significant improvement in New York Heart Association functional class (3.1 ± 0.1 vs 2.1 ± 0.1, P < 0.01), quality-of-life (QoL) score (62.9 ± 3.3 vs 56.1 ± 4.5, P = 0.02), left ventricular ejection fraction (LVEF, 28.8 ± 2.5% vs 38.1 ± 2.3%, P < 0.01), and reduction in pulmonary artery systolic pressure (PASP, 41.0 ± 2.7 vs 28.6 ± 2.2 mmHg; P < 0.01) compared with baseline. Repeated PSG after CRT demonstrated a reduction in the duration of arterial oxygen desaturation ≤95% (251.2 ± 36.7 vs 141.0 ± 37.1 minutes), AHI (27.5 ± 4.7 vs 18.1 ± 3.0, P = 0.05), and number of central sleep apnea (CSA) (7.8 ± 2.6 vs 3.0 ± 1.3/hour, P = 0.03), but not number of obstructive sleep apnea (OSA, 8.6 ± 3.3 vs 7.2 ± 2.3/hour, P = 0.65) compared to baseline. Percentage change in PASP was significantly correlated with percentage changes in LVEF (r = -0.57, P = 0.04), AHI (r = 0.5, P = 0.05), and number of CSA episodes (r = 0.55, P = 0.02). Conclusions: The results demonstrated that CRT significantly reduces CSA in patients with HF. Importantly, we have noted a decrement of PASP correlated to drop in CSA which maybe one of the mechanisms explaining this observation. Future studies are required to confirm our finding and elucidate other possible mechanisms in this regard. © 2008, The Authors.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAgeden_US
dc.subject.meshCardiac Pacing, Artificial - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Failure - Diagnosis - Prevention & Controlen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertension, Pulmonary - Diagnosis - Prevention & Controlen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshSleep Apnea, Central - Diagnosis - Prevention & Controlen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleAlleviation of pulmonary hypertension by cardiac resynchronization therapy is associated with improvement in central sleep apneaen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH:khkyiu@hku.hken_US
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_US
dc.identifier.emailIp, MSM:msmip@hku.hken_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.identifier.authoritySiu, CW=rp00534en_US
dc.identifier.authorityIp, MSM=rp00347en_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8159.2008.01222.xen_US
dc.identifier.pmid19067803-
dc.identifier.scopuseid_2-s2.0-56049089615en_US
dc.identifier.hkuros158482-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-56049089615&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume31en_US
dc.identifier.issue12en_US
dc.identifier.spage1522en_US
dc.identifier.epage1527en_US
dc.identifier.isiWOS:000261079300002-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridYiu, KH=35172267800en_US
dc.identifier.scopusauthoridLee, KLF=7501505962en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridSiu, CW=7006550690en_US
dc.identifier.scopusauthoridMiu, KM=16230630500en_US
dc.identifier.scopusauthoridLam, B=9246012800en_US
dc.identifier.scopusauthoridLam, J=25923453500en_US
dc.identifier.scopusauthoridIp, MSM=7102423259en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.citeulike3511192-

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