CPAP prevents atrial enlargement, boosts diastolic dysfunction reversibility in OSA, MS patients

Treatment with continuous positive airway pressure (CPAP) for 6 months deters atrial remodeling and improves the possibility of achieving diastolic dysfunction reversibility in patients with metabolic syndrome (MS) and obstructive sleep apnoea (OSA), a study has shown.

A group of researchers conducted a prespecified analysis of a randomized placebo-controlled trial to explore the role of OSA treatment on heart remodeling and diastolic function in MS patients. They enrolled those with a recent MS diagnosis and moderate-to-severe OSA, who then underwent either CPAP therapy or nasal dilators (placebo) for 6 months.

The researchers then invited the patients to undergo a transthoracic echocardiogram by a single investigator who was blinded to the treatment assignment.

Of the participants, 99 (mean age 48 years, body mass index 33 kg/m², 79 percent men) completed the study. Patients in the placebo group showed a significant increase in atrial diameter, from 39.5 to 40.5 mm (p=0.003) during follow-up. On the other hand, CPAP prevented atrial enlargement, from 40.0 to 40.0 mm (p=0.194).

Notably, nearly half of the patients with diastolic dysfunction at baseline achieved reversibility with CPAP relative to just two in the placebo group (p=0.039). Regression analysis revealed a 6.8-fold (95 percent confidence interval, 1.48‒50.26; p=0.025) likelihood of diastolic dysfunction reversibility by CPAP compared with placebo.