1. Echocardiographic changes with positive airway pressure in obesity hypoventilation syndrome. Pickwick study
- Author
-
Jose M. Marin, Babak Mokhlesi, Jaime Corral, Fco. Javier Gómez de Terreros, María Luz Alonso-Álvarez, Pilar de Lucas, Mª Victoria Mogollón, Trinidad Díaz-Cambriles, Teresa Gomez-Garcia, Joaquín Terán-Santos, Juan F. Masa, Carlos Egea, Candela Caballero, Auxiliadora Romero, Mª Ángeles Sanchez Quiroga, Javier Barca, Soledad Lopez-Martínez, Sergi Marti, and Mónica González
- Subjects
Spirometry ,Obesity hypoventilation syndrome ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Epworth Sleepiness Scale ,Polysomnography ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Positive airway pressure ,medicine ,Cardiology ,030212 general & internal medicine ,Continuous positive airway pressure ,Transthoracic echocardiogram ,business ,030217 neurology & neurosurgery - Abstract
There are no randomized controlled trials assessing the impact of noninvasive ventilation (NIV) and continuous positive airway pressure (CPAP) on cardiac function in obesity hypoventilation syndrome (OHS). Objective: To determine the efficacy of 2 months of NIV, CPAP or lifestyle modification (control) on echocardiographic changes. Method: OHS patients (n=302) were sequentially randomized by: 1) severe obstructive sleep apnea (OSA), into NIV, CPAP or control; 2) non-severe OSA, into NIV or control. ABG, spirometry, six-minute walk distance, Epworth sleepiness scale, polysomnography and transthoracic echocardiogram were evaluated. Results: We analyzed 2 groups: 1) with or without severe OSA and NIV or control treatments (entire OHS group; n=222); 2) with severe OSA and NIV, CPAP or control treatments (severe OSA subgroup; n=221). In the entire OHS group, NIV improved the left ventricular (LV) hypertrophy (mass index: -6.6 g/m2; 95%CI -11/-2.1 vs 3.6; 95%CI -1.1/8.3; adjusted p Conclusion: Medium-term NIV therapy is more effective than CPAP and lifestyle modification in improving PAP and LV hypertrophy in OHS
- Published
- 2017
- Full Text
- View/download PDF