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±43days).

RESULTS: 350 patients (mean age 68±10.7years, 88% male) were included, inspiratory vital capacity, 3.3±0.9 vs 3.2±0.8L; forced expiratory volume in 1s, 2.5±0.7 vs 2.4±0.7L; lung diffusion capacity, 6.2±1.9 vs 5.9±1.8mmol/min/kPa; correction for hemoglobin, 1.1±0.02 vs 1.1±0.3mmol/min/kPa/L; and mouth occlusion pressure, 0.42±0.11 vs 0.4±0.12kPa.

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.