Positive airway pressure therapy in heart failure patients: Long-term effects on lung function

Purpose: The prevalence of sleep-disordered breathing (SDB) in patients with heart failure (HF) is high. Positive airway pressure (PAP) is first-choice therapy, but recent data indicates that PAP therapy may increase mortality in HF patients with reduced ejection fraction (HF-REF) and predominant central sleep apnea (CSA). This study investigated long-term effects of PAP therapy On pulmonary function, including respiratory muscle strength. All patients underwent multichannel cardiorespiratory polysomnography (PSG) and comprehensive lung function testing at baseline and follow-Up (mean 588 +/- 43 days). Results: 350 patients (mean age 68 +/- 10.7 years, 88% male) were included, inspiratory vital capacity, 3.3 +/- 0.9 vs 3.2 +/- 0.8 L; forced expiratory volume in 1 s, 2.5 +/- 0.7 vs 2.4 +/- 0.7 L; lung diffusion capacity, 6.2 +/- 1.9 vs 5.9 +/- 1.8 mmol/min/kPa; correction for hemoglobin, 1.1 +/- 0.02 vs 1.1 +/- 0.3 mmoliminikPaiL; and mouth occlusion pressure, 0.42 +/- 0.11 vs 0.4 +/- 0.12 kPa. Conclusions: PAP therapy had no negative nor positive impact on lung function, including respiratory muscle strength, in stable HF-REF patients with SDB, and is therefore safe from a respiratory perspective. (C) 2017 Elsevier B.V. All rights reserved.