Continuous positive airway pressure on left ventricular ejection fraction in obstructive sleep apnea and heart failure with reduced ejection fraction: a systematic review and meta-analysis

持续气道正压通气对阻塞性睡眠呼吸暂停和射血分数降低的心力衰竭患者左心室射血分数的影响:系统评价和荟萃分析

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Abstract

Continuous positive airway pressure (CPAP) is the primary treatment for obstructive sleep apnea (OSA), with fixed pressure CPAP (FP-CPAP) and auto-titrating CPAP (Auto-CPAP) being the two modes. We examined the impact of CPAP on left ventricular ejection fraction (LVEF) in patients with OSA and heart failure with reduced ejection fraction (HFrEF). A meta-analysis of 10 randomized control trials (233 CPAP users, 242 controls) was conducted. LVEF was the primary outcome. CPAP significantly increased LVEF (mean difference: 3.72, 95% CI 2.21-5.23). FP-CPAP improved LVEF (4.84, 95% CI 3.23-6.45), while Auto-CPAP showed no significant effect. The cardiovascular benefits of CPAP in patients with OSA and HFrEF may vary by mode, suggesting a potential mode-specific effect between FP-CPAP and Auto-CPAP that warrants further investigation.

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