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Am. J. Respir. Crit. Care Med., Volume 161, Number 1, January 2000, 128-134

Effects of Continuous Positive Airway Pressure on Cardiac Volumes in Patients with Ischemic and Dilated Cardiomyopathy

SANGEETA MEHTA, PETER P. LIU, FABIA S. FITZGERALD, YASMIN K. ALLIDINA, and T. DOUGLAS BRADLEY

Departments of Medicine of The Toronto Hospital and Mount Sinai Hospital, the Nuclear Cardiology Laboratory of the Toronto Hospital and the Centre for Cardiovascular Research, the Department of Medicine of the University of Toronto, Toronto, Ontario, Canada

The effects of continuous positive airway pressure (CPAP) on left (LV) and right ventricular (RV) volumes in patients with congestive heart failure (CHF) have not been studied. We hypothesized that CPAP would cause greater reductions in cardiac volumes in CHF patients with idiopathic dilated cardiomyopathy (IDC) than in those with ischemic cardiomyopathy (IsC), because their ventricles are more compliant. The effects of a 30-min CPAP application at 10 cm H2O on RV and LV end-diastolic (EDV) and end-systolic volumes (ESV), determined by radionuclide angiography, were therefore tested in 22 patients with CHF due to IsC (n = 13) or IDC (n = 9). CPAP-induced reductions in LVEDV, LVESV, RVEDV, and RVESV were significantly greater (p < 0.05) in the IDC than in the IsC group. Whereas in the IsC group CPAP caused no significant changes in LV or RV volumes, in the IDC group it induced significant reductions in RVEDV (527 ± 77 ml to 354 ± 50 ml, p = 0.03) and RVESV (400 ± 78 ml to 272 ± 54 ml, p = 0.04) that were greater than any reductions in LVEDV and LVESV. We conclude that CPAP causes greater short-term reductions in RV and LV volumes in CHF patients with IDC than in those with IsC, and that among patients with IDC, CPAP causes greater reductions in RV than in LV volumes. Mehta S, Liu PP, Fitzgerald FS, Allidina YK, Bradley TD. Effects of continuous positive airway pressure on cardiac volumes in patients with ischemic and dilated cardiomyopathy.




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