OBJECTIVE: The purpose of this study was to evaluate the acute effects of continuous positive airway pressure (CPAP) and bi-level airway pressure (BiPAP) on functional mitral regurgitation (MR) in patients with acute exacerbation of severe chronic congestive heart failure (CHF). DESIGN: A cross-over study. SETTING: A cardiopulmonary intensive care unit. PATIENTS AND INTERVENTIONS: Ten male patients affected by an acute exacerbation of congestive heart failure and hemodynamically significant MR were submitted to an echocardiograph color Doppler ultrasound evaluation during CPAP and BiPAP non-invasive ventilation. We analyzed left ventricle ejection fraction, area of MR and deceleration time (Dec-t). OUTCOME MEASURES: The primary end point was to evaluate whether CPAP and BiPAP were effective in reducing functional MR. RESULTS: After 30 min, the area of MR decreased from 10.0+/-2.7 to 8.0+/-2.9 cm(2) with CPAP and from 9.9+/-2.6 to 8.6+/-2.6 cm(2) with BiPAP ( p<0.01); Dec-t increased from 120.9+/-12.7 to 136.0+/-8.7 ms after CPAP and from 120.5+/-11.4 to 134.2+/-13.6 ms after BiPAP ( p<0.01). CONCLUSION: In patients with exacerbation of severe CHF and functional MR, both modalities of non-invasive ventilation (CPAP and BiPAP) significantly improved ejection fraction and were equally effective in reducing MR.
OBJECTIVE: The purpose of this study was to evaluate the acute effects of continuous positive airway pressure (CPAP) and bi-level airway pressure (BiPAP) on functional mitral regurgitation (MR) in patients with acute exacerbation of severe chronic congestive heart failure (CHF). DESIGN: A cross-over study. SETTING: A cardiopulmonary intensive care unit. PATIENTS AND INTERVENTIONS: Ten male patients affected by an acute exacerbation of congestive heart failure and hemodynamically significant MR were submitted to an echocardiograph color Doppler ultrasound evaluation during CPAP and BiPAP non-invasive ventilation. We analyzed left ventricle ejection fraction, area of MR and deceleration time (Dec-t). OUTCOME MEASURES: The primary end point was to evaluate whether CPAP and BiPAP were effective in reducing functional MR. RESULTS: After 30 min, the area of MR decreased from 10.0+/-2.7 to 8.0+/-2.9 cm(2) with CPAP and from 9.9+/-2.6 to 8.6+/-2.6 cm(2) with BiPAP ( p<0.01); Dec-t increased from 120.9+/-12.7 to 136.0+/-8.7 ms after CPAP and from 120.5+/-11.4 to 134.2+/-13.6 ms after BiPAP ( p<0.01). CONCLUSION: In patients with exacerbation of severe CHF and functional MR, both modalities of non-invasive ventilation (CPAP and BiPAP) significantly improved ejection fraction and were equally effective in reducing MR.
Authors: Sean P Keenan; Tasnim Sinuff; Karen E A Burns; John Muscedere; Jim Kutsogiannis; Sangeeta Mehta; Deborah J Cook; Najib Ayas; Neill K J Adhikari; Lori Hand; Damon C Scales; Rose Pagnotta; Lynda Lazosky; Graeme Rocker; Sandra Dial; Kevin Laupland; Kevin Sanders; Peter Dodek Journal: CMAJ Date: 2011-02-14 Impact factor: 8.262