The Effects of Continuous Positive Airways Pressure Therapy on Cardiovascular End Points in Patients With Sleep‐Disordered Breathing and Heart Failure: A Meta‐Analysis of Randomized Controlled Trials

Abstract In patients with sleep‐disordered breathing and heart failure, continuous positive airway pressure has been found to be associated with an improvement in cardiovascular end points. We conducted a systematic review of the current literature and a meta‐analysis to pool data from 15 published randomized controlled trials. End points analyzed were left ventricular ejection fraction, diastolic blood pressure, systolic blood pressure, heart rate, and mortality. A fixed effects model was used for end points demonstrating homogeneity among included studies, whereas a random effects model was used for end points demonstrating heterogeneity among included studies. A significant improvement in left ventricular ejection fraction was noted with continuous positive airway pressure (mean difference, 5.05%; 95% confidence interval [CI]: 3.72 to 6.38), diastolic blood pressure (mean difference, −1.67; 95% CI: −3.09 to −0.25), and heart rate (mean difference, −5.92; 95% CI: −10.12 to −1.72). No significant changes in mortality (odds ratio, 0.63; 95% CI: 0.40 to 1.00) and systolic blood pressure were noted (mean difference, −6.35; 95% CI: −16.11 to 2.41). The analysis also revealed the need for additional studies to clarify the associations noted and the presence of publication bias with small studies with a paucity of small studies with negative results. In this meta‐analysis, treatment with continuous positive airways pressure was...
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Reviews Source Type: research

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AbstractBackgroundPatient-related risk factors for the development of postoperative pulmonary complications (PPCs) include age  ≥ 60-years, congestive heart failure, hypoalbuminemia and smoking. The effect of obesity is unclear and has not been shown to independently increase the likelihood of PPCs in trauma patients undergoing trauma laparotomy. We hypothesized the likelihood of mortality and PPCs would increase as b ody mass index (BMI) increases in trauma patients undergoing trauma laparotomy.MethodsThe Trauma Quality Improvement Program (2010 –2016) was queried to identify trauma patients ...
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
Background: Total hip arthroplasty (THA) is an effective treatment for symptomatic osteoarthritis after failed nonsurgical therapies. Minimizing perioperative complications is critical for faster recovery and shorter hospital stay. The primary aim of this study was to identify predictors of perioperative major complications (MC) and mortality after THA, and to use these predictors to develop a risk scoring system. Methods: The 2006-2016 National Surgical Quality Improvement Program (NSQIP) database was queried for adult patients who underwent primary elective THA performed under general or neuraxial anesthesia. Univar...
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: Original Research Source Type: research
Authors: Chiba Y, Fukushima A, Nakao M, Kobayashi Y, Ishigaki T, Tenma T, Kamiya K, Shingu Y, Ooka T, Matsui Y, Anzai T Abstract A 23-year-old man had progressive muscle weakness and Emery-Dreifuss muscular dystrophy (EDMD) due to a LMNA (lamin A/C) mutation. Congestive heart failure diagnosed at 19 years of age. Maximal drug treatment/cardiac resynchronization failed to improve the cardiac function. He was therefore hospitalized due to heart failure. Despite extracorporeal membrane oxygenation, he developed severe right heart dysfunction and died (multiple organ failure). A cardiac lesion's presence determines the...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Hakim SM, Elfawy DM, Elserwi HB, Saad MK Abstract INTRODUCTION: The aim of this review is to examine current evidence on value of new ST-segment or T-wave changes for prediction of major adverse cardiac events (MACE) after vascular surgery. EVIDENCE ACQUISITION: We searched PudMed, EMBASE and Cochrane Library databases for studies examining the relation between new ST-segment elevation or depression or T-wave inversion and MACE following vascular surgery. MACE was defined as fatal or non-fatal myocardial infarction, cardiac death, unstable angina, cardiac arrest, congestive heart failure, ischemic pulm...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
AbstractTo investigate the potential effect of intracoronary administration of the glycoprotein IIb/IIIa inhibitor tirofiban on the microvascular obstruction (MVO) assessed by cardiac magnetic resonance (CMR) imaging compared to the intravenous route in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Two hundred eight patients were randomized into two groups (tirofiban i.v. and tirofiban i.c.). CMR was completed within 3 –7 days after ST-segment-elevation myocardial infarction. One hundred thirty-two patients had a follow-up CMR at 6 mont...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
This study enrolled an institutional consecutive surgical series of 24 patients with refractory congestive heart failure under peripheral ECLS, related to fulminant myocarditis (n = 15), dilated cardiomyopathy (n = 5), or acute myocardial infarction (n = 4). They were converted to central Y-extracorporeal membrane oxygenation (ECMO,n = 6), extracorporeal ventricular assist device (EC-VAD,n = 12), or pump catheter (n = 6), dependent upon the degree of multiorgan failure. Despite the different degree of multiorgan failure prior to the convers...
Source: Journal of Artificial Organs - Category: Transplant Surgery Source Type: research
Pneumonia has been a serious cause of morbidity and mortality for many years and, more than 100 years ago, Sir William Osler referred to it as "the natural enemy of the old man" [1]. Many studies have documented that elderly individuals have a higher frequency of illness, increased mortality and more subtle clinical features compared to younger populations. This too was known by Osler who commented that "it is not improbable that debility lowers the vitality and renders the individual susceptible" and when the illness occurs, it can be "without chill; the cough and expectoration are slight&quo...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Epidemiology, occupational and environmental lung disease, Respiratory infections and tuberculosis Editorial Source Type: research
Watch this 25-minute film of a patient who does VSED. "My mother had congestive heart failure and decided not to submit herself to the indignities of medical intervention. When she got too weak to get out of bed, she decided to stop eating and drinking (in German it’s called Sterbefasten or Death Fast, in the US it’s called VSED – Voluntarily Stopping Eating and Drinking)." "My outspoken mother insisted I film our family as we navigated this fraught process together. My brother and I cared for her round the clock during the ten days it took her to die at home. We then washed her body, set h...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
Discussion of the Evolutionary Genetics of Aging Thymic Involution Contributes to Immunosenescence and Inflammaging The Potential for Exosome Therapies to Treat Sarcopenia Correlations of Mitochondrial DNA Copy Number and Epigenetic Age Measures Evidence for PASK Deficiency to Reduce the Impact of Aging in Mice The Aging Retina, a Mirror of the Aging Brain Evidence for Loss of Capillary Density to be Important in Heart Disease Aspects of Immune System Aging Proceed More Rapidly in Men Deacetylation of the NLRP3 Inflammasome as a Way to Control Chronic Inflammation Transplantation of Senescent Cells is an ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We describe a patient who presented with congestive heart failure that required a left ventricular assist device and a temporary right ventricular assist device along with immunosuppressive therapy. This case also brings to attention how undocumented immigration status can limit transplantation opportunities in the USA.
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
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