Reverse Remodelling of LV in HF Patients with CPAP

[Tinu1959]

Dear Forum Members, I have come across information reproduced below. Does anyone know what is Continuous Positive Airways Pressure(CPAP) Theraphy? Has it helped someone you know?

"Non-pharmacological approaches for inducing reverse remodeling

Long-term moderate exercise training has been shown to induce reverse remodeling in patients with stable chronic heart failure, and this was associated with significant increases in work capacity and peak oxygen uptake. Central and obstructive sleep apnea is highly prevalent in patients with asymptomatic and symptomatic left ventricular dysfunction and is associated with impaired prognosis. Sin et al. demonstrated the effectiveness of continuous positive airway pressure (CPAP) therapy in heart failure patients and central sleep apnea: ventricular function significantly improved after 3 months, associated with a relative 81% risk reduction for mortality or cardiac transplantation. Recently, in a randomized trial in 55 patients, CPAP therapy for 3 months improved ventricular function and reduced sympathetic activity in patients with heart failure and obstructive sleep apnea (OSA). Likewise, CPAP therapy in OSA patients reduced daytime blood pressure and heart rate, and was associated with a significant reduction in left ventricular end-systolic dimensions and increases in ejection fraction."
Source: http://eurheartjsupp.oxfordjournals.org/cgi/content/full/6/suppl_D/D66

[Tinu1959]

The article which I have referred talkes about reversal of LV Remodeling. This theraphy mostly used for sleep disorders. What I want to know is, whether it has application and corrective impact on patients who do not suffer from sleep disorders but have LV dilation/enlargement. Has someone experience of using this theraphy without having sleep disorders?

[maggiemag]

A very high percentage of heart failure patients have sleep disordered breathing, I think about 80%.  That means that they might have sleep apnea where they stop breathing sometimes, or hypoventilate and not breath deeply enough, or other breathing problems.  Many need oxygen during sleep.  Most of these people are untreated and have no idea they have a problem.  CPAP can help some and this reduces the work of the heart and lowers BP  that can elevate with sleep disordered breathing. CPAP can help lower elevated pulmonary pressures as well for those with SDB.   I suppose you could ask your doctor if it would be appropriate for you to have a sleep study or at least an overnight oximetry to see if you have a problem.