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Efficacy of Positive Airway Pressure on Brain Natriuretic Peptide in Patients with Heart Failure and Sleep-Disorder Breathing: A Meta-analysis of Randomized Controlled Trials

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Abstract

Objective

Positive airway pressure (PAP) has been recognized as an effective therapeutic option for sleep-disordered breathing (SDB) in patients with heart failure (HF), and it can improve left ventricular function. Whether PAP can ameliorate serum brain natriuretic peptide (BNP) levels, a biomarker of HF, is controversial. The purpose of the present study was to quantitatively assess the efficacy of PAP on BNP in patients with HF and SDB.

Methods

A systematic search of PubMed, Embase, Web of Science and Cochrane library identified six randomized controlled trials (RCTs), in which PAP was compared with medical therapy, subtherapeutic PAP or different types of PAP. The data of BNP were extracted and pooled into meta-analysis using STATA 12.0.

Results

Totally 6 RCT studies (7 cohorts) with 222 patients were enrolled into analysis. The quality of each study was high and the heterogeneity (I 2 = 58.1 %) was noted between studies. A significant reduction of BNP was observed after PAP treatment in patients with HF and SDB (SMD −0.517, 95 % CI −0.764 to −0.270, z = 4.11, p = 0.000).

Conclusion

Our meta-analysis of RCTs demonstrated that PAP elicits significant reduction of BNP in patients with HF and SDB.

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Acknowledgments

This work was supported by Grant 2013-2-88 for Youth Research Fund from Fujian Provincial Health Bureau.

Conflict of interest

The authors declare that they have no conflict of interest.

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    Authors and Affiliations

    1. Department of Respiratory Medicine, Zhongshan Hospital, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, 361004, Fujian, China

      Xiao-Bin Zhang, Ya-Ting Yuan, Yan-Ping Du, Xing-Tang Jiang & Hui-Qing Zeng

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    1. Xiao-Bin Zhang
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    2. Ya-Ting Yuan
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    Correspondence to Xiao-Bin Zhang.

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    All authors contributed equally to this work.

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    Zhang, XB., Yuan, YT., Du, YP. et al. Efficacy of Positive Airway Pressure on Brain Natriuretic Peptide in Patients with Heart Failure and Sleep-Disorder Breathing: A Meta-analysis of Randomized Controlled Trials. Lung 193, 255–260 (2015). https://doi.org/10.1007/s00408-015-9684-z

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    • DOI: https://doi.org/10.1007/s00408-015-9684-z

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