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Obstructive sleep apnea (OSA) often coexists with heart failure and may contribute to HF progression by increasing left-ventricular afterload, hypoxia, and sympathetic activation. Continuous positive airway pressure (CPAP) therapy has been shown to improve LV ejection fraction (LVEF) in patients with OSA and LV systolic dysfunction, but does the improvement come at the expense of myocardial efficiency?
To find out, researchers at a Canadian center studied 12 men with stable, symptomatic systolic HF (5 nonischemic): The 7 with polysomnography-documented OSA (6 of whom were obese) were treated nightly with CPAP for a mean of 6 weeks; the 5 without OSA (1 was obese) were not. All 12 patients were taking beta-blockers and either an ACE inhibitor…