Abstract 2050: Long-term Outcome of Continuous Positive Airway Pressure Therapy in Non-obese Patients with Obstructive Sleep Apnea and Heart Failure
Background: Continuous positive airway pressure (CPAP) had been shown as an effective therapy for obstructive sleep apnea (OSA) complicated with heart failure (HF). However, the efficacy of CPAP in non-obese patients remains unknown and in addition, there were no data about long-term outcome following CPAP initiation in such patients.
Methods: 52 consecutive patients with OSA and HF who were initiated into CPAP were analyzed. Patients were divided into 2 groups according to their body mass index ≥25 (obese group: O) or <25 (non-obese group: NO). LVEF and plasma norepinephrine (NE) were assessed at the baseline and 3 months later. Then, the patients were followed up for long-term clinical events (composite of death and hospitalization due to HF)
Results: The baseline characteristics were similar between O (n=24) and NO (n=28). LVEF and NE showed significant improvements in both groups [LVEF +8% (P=.0003) in O, +6% (P=.005) in NO, NE -74pg/ml (P=.04) in O and −32.5 pg/ml (P=.047) in NO]. The improvement of LVEF and NE were significantly greater in O (P=.032 in LVEF, P=.03 in NE). During follow-up (mean: 20.4 months), there were significant differences in the incidence of clinical events (10.7% in O, 37.5% in NO, P=.015). After adjustment of age and baseline LVEF, NO group had significantly higher incidence of clinical events (HR6.24, 1.45–16.9, P=.014). The compliance for CPAP during initial 3 months was poorer in NO than in O (P=.042)
Conclusion: The treatment with CPAP for OSA had an efficacy for underling HF even in NO. However, the long-term outcome was significantly worse in NO than in O due to poorer compliance for CPAP.