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Sleep and Breathing

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10.05.2023 | Sleep Breathing Physiology and Disorders • Original Article

Effect of continuous positive pressure ventilation on left ventricular diastolic function E/A ratio in patients with obstructive sleep apnea: a meta-analysis

verfasst von: Jie Feng, Kai Li, Wei Luo, Feng Xie, Meng Li, Yanqing Wu

Erschienen in: Sleep and Breathing | Ausgabe 6/2023

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Abstract

Purpose

Many studies have shown that obstructive sleep apnea (OSA) is related to reduced left ventricular diastolic function. Continuous positive airway pressure (CPAP) is generally recognized as the preferred therapy for OSA. Yet, the effect of CPAP on left ventricular diastolic function in patients with OSA is inconclusive. In order to assess the influence of CPAP on left ventricular diastolic function in patients with OSA, we performed this meta-analysis of clinical experiments.

Methods

PubMed, Web of Science, OVID, Embase, and Cochrane Library from the establishment of the database to July 6, 2022, were searched for clinical trial data. Inclusion criteria for this meta-analysis were: (1) Patients in the experimental group were diagnosed with OSA by polysomnography; (2) CPAP treatment course ≥ 4 weeks; (3) baseline and follow-up data of the diastolic function parameter E/A ratio were reported in the literature. Exclusion criteria were: (1) Central sleep apnea (CSA); (2) comorbid organic heart diseases such as coronary heart disease; (3) age < 18 years old; (4) conference abstracts or duplicate publications.

Results

After exclusions, 7 studies (2 RCTs and 5 prospective studies) with 473 subjects (225 in the treatment group and 248 in the matched control group) were included in the meta-analysis. Subgroup analysis indicated that after CPAP therapy, the left ventricular (LV) E/A ratio was significantly increased in patients with OSA (weighted mean difference (WMD) = 0.22, 95% CI = − 0.06–0.38; P = 0.007). Sensitivity analyses showed that the combined results were not influenced by single studies. Publication bias was not significant (Egger’s test, P = 0.813).

Conclusions

The results of this meta-analysis suggest that CPAP may improve the E/A ratio in patients with OSA patients. However, the small number of studies (n = 7) decreases confidence in the findings. Thus, carefully designed randomized controlled trials are needed to confirm the findings.

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Titel: Effect of continuous positive pressure ventilation on left ventricular diastolic function E/A ratio in patients with obstructive sleep apnea: a meta-analysis
verfasst von: Jie Feng
Kai Li
Wei Luo
Feng Xie
Meng Li
Yanqing Wu
Publikationsdatum: 10.05.2023
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 6/2023
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-023-02836-x

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Effect of continuous positive pressure ventilation on left ventricular diastolic function E/A ratio in patients with obstructive sleep apnea: a meta-analysis