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一项关于持续气道正压通气(CPAP)治疗对罗马尼亚阻塞性睡眠呼吸暂停患者队列心血管结局影响的前瞻性研究。

A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients.

作者信息

Chetan Ioana Maria, Maierean Anca Diana, Domokos Gergely Bianca, Cabau Georgiana, Tomoaia Raluca, Chis Ana Florica, Albu Adriana, Stoia Mirela Anca, Vesa Stefan Cristian, Blendea Dan, Todea Doina Adina

机构信息

Department of Pneumology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania.

Heart Institute "Nicolae Stancioiu", 400001 Cluj-Napoca, Romania.

出版信息

J Pers Med. 2021 Oct 2;11(10):1001. doi: 10.3390/jpm11101001.

Abstract

BACKGROUND

Despite efforts at treatment, obstructive sleep apnea (OSA) remains a major health problem, especially with increasing evidence showing an association with cardiovascular morbidity and mortality. The treatment of choice for OSA patients is Continuous Positive Airway Pressure (CPAP), which has been proven in randomized controlled trials to be an effective therapy for this condition. The impact of CPAP on the cardiovascular pathology associated with OSA remains, however, unclear. Although the effect of CPAP has been previously studied in relation to cardiovascular outcome, follow-up of the treatment impact on cardiovascular risk factors at one year of therapy is lacking in a Romanian population. Thus, we aimed to evaluate the one-year effect of CPAP therapy on lipid profile, inflammatory state, blood pressure and cardiac function, assessed by echocardiography, on a cohort of Romanian OSA patients.

METHODS

We enrolled 163 participants and recorded their baseline demographic and clinical characteristics with a follow-up after 12 months. Inflammatory and cardiovascular risk factors were assessed at baseline and follow up.

RESULTS

Our results show that CPAP therapy leads to attenuation of cardiovascular risk factors including echocardiographic parameters, while having no effect on inflammatory markers.

CONCLUSION

Treatment of OSA with CPAP proved to have beneficial effects on some of the cardiovascular risk factors while others remained unchanged, raising new questions for research into the treatment and management of OSA patients.

摘要

背景

尽管进行了治疗,但阻塞性睡眠呼吸暂停(OSA)仍然是一个主要的健康问题,尤其是越来越多的证据表明它与心血管疾病的发病率和死亡率有关。OSA患者的首选治疗方法是持续气道正压通气(CPAP),随机对照试验已证明这是治疗该疾病的有效方法。然而,CPAP对与OSA相关的心血管病理的影响仍不清楚。尽管之前已经研究了CPAP对心血管结局的影响,但罗马尼亚人群缺乏对治疗一年后心血管危险因素的治疗影响的随访。因此,我们旨在评估CPAP治疗对一组罗马尼亚OSA患者的血脂谱、炎症状态、血压和通过超声心动图评估的心脏功能的一年影响。

方法

我们招募了163名参与者,记录了他们的基线人口统计学和临床特征,并在12个月后进行了随访。在基线和随访时评估炎症和心血管危险因素。

结果

我们的结果表明,CPAP治疗可导致包括超声心动图参数在内的心血管危险因素减弱,而对炎症标志物没有影响。

结论

事实证明,用CPAP治疗OSA对一些心血管危险因素有有益影响,而其他因素则保持不变,这为OSA患者的治疗和管理研究提出了新的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbcf/8540427/55bdaab2e68f/jpm-11-01001-g001.jpg

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