Positive Airway Pressure Therapy for Sleep Disordered Breathing in Congestive Heart Failure is Associated with Reduction in Pulmonary Artery Systolic Pressure

Background: Sleep disordered breathing and pulmonary hypertension are both highly prevalent in patients with congestive heart failure (CHF). Since (SDB) has been shown to increase pulmonary pressures, we hypothesized that initiation of positive airway pressure (PAP) may reduce pulmonary artery systolic pressure (PASP) in compliant patients.

Methods: A total of 125 consecutive CHF patients admitted for decompensation were screened. Of these patients, 18 met inclusion criteria for the study which included a PASP ≥ 36 and polysomnogram-proven SDB. A repeat echocardiogram performed at mean 8 weeks post intervention was reviewed to compare PASP.

Results: There was no statistically significant difference in mean age, BMI, AHI, baseline PASP, and ejection fraction between the PAP-compliant group and PAP non-compliant group. A statistically significant mean reduction in PASP of 13.8 ± 7.0 mmHg (range: -25, -1) was observed in CHF patients with SDB who were compliant with PAP therapy, versus a mean increase of 0.9 ± 8.7 mmHg (range: -8, 15) in heart failure patients with SDB who were noncompliant with PAP therapy.

Conclusions: The findings suggest that PAP therapy is associated with improvement in pulmonary hypertension with congestive heart failure and sleep disordered breathing.