Effect of continuous positive airway pressure on atrial remodeling and diastolic dysfunction of patients with obstructive sleep apnea and metabolic syndrome: a randomized study
Authors' conclusion
In patients with MS and OSA, 6 months of CPAP therapy prevented atrial remodeling and increased the chance of diastolic dysfunction reversibility.
Study context
- Population
- Patients with recent diagnosis of metabolic syndrome and moderate-to-severe obstructive sleep apnea (OSA); 79% men, mean age 48 years, BMI 33 kg/m²completed the study
- Participants
- 99 patients
- Comparison
- Continuous positive airway pressure (CPAP) vs nasal dilators
- Primary endpoint
- Heart remodeling (atrial diameter) and diastolic dysfunction on transthoracic echocardiogram
- Follow-up
- 6 months
Methodological detailsplacebo-controlled, blinded echocardiography assessor
- Placebo-controlled
- Blinded echocardiography assessor
Primary result
As reported in the abstract
Atrial diameter, baseline to follow-up
- Placebo: 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
Further findings
| Outcome | Chance of reversibility (regression analysis) (95% CI) | P value |
|---|---|---|
| Diastolic dysfunction reversibility in patients with diastolic dysfunction at baseline · 6 monthsCPAP vs Placebo · almost half with CPAP vs only two patients with placebo | P = 0.039 | |
| Diastolic dysfunction reversibility in patients with diastolic dysfunction at baseline · 6 monthsCPAP vs Placebo | 6.8-fold (1.48–50.26) | P = 0.025 |
Original publication
Effect of continuous positive airway pressure on atrial remodeling and diastolic dysfunction of patients with obstructive sleep apnea and metabolic syndrome: a randomized study. Obesity (Silver Spring). Published 28 February 2023. doi:10.
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