Dados do Trabalho

Título

Effect of CPAP on Atrial Remodeling and Diastolic Dysfunction of Patients with OSA and Metabolic Syndrome: A Randomized Study

Introdução

Metabolic Syndrome (MS) is associated with heart remodeling and diastolic dysfunction. Considering that Obstructive Sleep Apnea (OSA) is common in patients with MS and its treatment may reverse MS, it would be important to evaluate the role of OSA treatment on diastolic dysfunction in patients with MS.

Objetivo

To evaluate the role of OSA treatment on heart remodeling and diastolic dysfunction in patients with MS.

Métodos

This study is a prespecified analysis of a randomized placebo-controlled trial that enrolled patients with a recent diagnosis of MS, and moderate/severe OSA to undergo continuous positive airway pressure (CPAP) or nasal strips (placebo) for 6 months. Patients were invited to perform a transthoracic echocardiogram using standard recommendations by a single investigator without access to the sleep studies/treatments.

Resultados

Ninety-nine patients (79% men; age: 48±9 years; body mass index: 33±4 kg/m2) completed the study. At follow-up, in the placebo group, patients had a significant increase in atrial diameter: from 39.5 [37.0–43.0] mm to 40.5 [39.0–44.8] mm (p=0.03). CPAP prevented atrial enlargement. In patients with diastolic dysfunction at baseline, almost half of them had diastolic dysfunction reversibility with CPAP (in comparison with only 2 patients in the placebo group, p=0.039). In the regression analysis, the chance of diastolic dysfunction reversibility by CPAP was 6.8 fold (CI: 1.48–50.26, p=0.025).

Conclusões

In patients with MS and OSA, 6-months of CPAP therapy prevented atrial remodeling and increased the chance of diastolic dysfunction reversibility.

Palavras -chave

continuous positive airway pressure; sleep apnea, metabolic syndrome; randomized controlled trial, diastolic dysfunction.