Effect of continuous positive airway pressure on atrial remodeling and diastolic dysfunction of patients with obstructive sleep apnea and metabolic syndrome: a randomized study

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Macedo, Thiago Andrade ; Giampa, Sara Q. C. ; Furlan, Sofia F. ; Freitas, Lunara S. ; Lebkuchen, Adriana ; Cardozo, Karina H. M. ; Carvalho, Valdemir M. ; Martins, Franco C. ; Mendonca, Tiago ; Bortolotto, Luiz A. ; Lorenzi-Filho, Geraldo ; Drager, Luciano F.

• Tipo de documento: Artigo Científico
• Fonte: OBESITY; v. 31, n. 4, p. 11-pg., 2023-02-28.

Resumo

Objective: The aim of this study was to evaluate the role of obstructive sleep apnea (OSA) treatment on heart remodeling and diastolic dysfunction in patients with metabolic syndrome (MS).Methods: This study is a prespecified analysis of a randomized placebo-controlled trial that enrolled patients with a recent diagnosis of MS and moderate-to-severe OSA to undergo continuous positive airway pressure (CPAP) or nasal dilators (placebo) for 6 months. Patients were invited to perform a transthoracic echocardiogram by a single investigator blinded to treatment assignment.Results: A total of 99 (79% men; mean [SD], age: 48 [9] years; BMI: 33 [4] kg/m(2)) completed the study. At follow-up, in the placebo group, patients had a significant increase in atrial diameter: from 39.5 (37.0-43.0) mm to 40.5 (39.0-44.8) mm (p = 0.003). CPAP prevented atrial enlargement: from 40.0 (38.0-44.0) to 40.0 (39.0-45.0) mm (p = 0.194). In patients with diastolic dysfunction at baseline, almost half had diastolic dysfunction reversibility with CPAP (in comparison with only two patients in the placebo group, p = 0.039). In the regression analysis, the chance of diastolic dysfunction reversibility by CPAP was 6.8-fold (95% CI: 1.48-50.26, p = 0.025) compared with placebo.Conclusions: In patients with MS and OSA, 6 months of CPAP therapy prevented atrial remodeling and increased the chance of diastolic dysfunction reversibility. (AU)

• Processo FAPESP: 19/23496-8 - Impacto dos distúrbios do sono na hipertensão arterial: uma abordagem multifacetada
• Beneficiário: Luciano Ferreira Drager
• Modalidade de apoio: Auxílio à Pesquisa - Temático