To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Research Show That Breathing Aid Can Help Heart Failure Patients URL: http://www.pslgroup.com/dg/6146.htm Doctor's Guide January 22, 1996
TORONTO, Jan. 22, 1996 -- Researchers at The Toronto Hospital have found that patients who have both congestive heart failure and a sleep disorder known as sleep apnea have dramatic improvement in heart function following the use of a breathing aid at night to treat the sleep apnea. The study also showed for the first time that by using Continuous Positive Airway Pressure (CPAP), the weakness of the respiratory muscle (diaphragm), usually found in patients with congestive heart failure, is reversed. In addition, the subjects iners air through a mask to the lungs at night and is a non-drug therapy for sleep apnea. Sleep apnea is a condition in which the throat collapses during sleep causing the individual to stop breathing temporarily. The intermittent periods of suffocation cause people to wake up and leave them feeling tired. However, not only do people with sleep apnea complain of tiredness, many also suffer from cardiovascular disease including congestive heart failure. The cardiovascular disease is worsened by the excess pressure the heart undergoes during the intermittent periods of apnea. Approximately 40 per cent of heart failure patients have sleep apnea compared to 6 per cent of the non-heart failure population. "This study shows that by using CPAP, patients with heart failure who are on maximum drug therapy for their cardiovascular disease had great improvement in their overall heart function, and strengthened their diaphragm muscle as well,'' says Dr. Douglas Bradley, Director of the Cardiorespiratory Sleep Disorder Clinic at The Toronto Hospital, and lead investigator of the study. An Associate Professor of Medicine at the University of Toronto, Dr. Bradley's specialty is respirology. "The strengthened diaphragm muscle also reduced shortness of breath which is the main symptom of heart failure.'' Dr. Bradley also directs a second research lab at Queen Elizabeth Hospital. Heart failure is a weakness of the heart muscle that impedes its ability to pump blood for proper circulation causing patients to experience fatigue and shortness of breath. It frequently occurs following a heart attack and is the fastest growing cardiovascular disease. Heart failure affects 5 per cent of Canadians and 50 per cent of these die within four years of diagnosis. Little is understood about the cause and progression of this debilitating heart muscle disease. The only eventual treatment is heart transplantation. "The use of CPAP allows the heart and diaphragm muscles to rest and recover strength,'' Dr. Bradley explains. "Basically we are dealing with fatigued muscles and by giving them a rest theyare able to function better. This is what causes the improvement in the function of these muscles.'' Nine patients with heart failure were enrolled in the study and were compared to nine healthy people in a control group. The patients in the study used CPAP for six hours a night. Both groups were followed over a three-month period. Patients also completed a detailed questionnaire which measured their quality of life. These questionnaires showed a dramatic improvement in quality of life, Dr. Bradley says. Dr. Bradley worked in collaboration with Dr. Peter Liu, a Toronto Hospital cardiologist, and Dr. John Granton, a Toronto Hospital respirologist. The study was published in the January 7 issue of the American Journal of Respiratory and Critical Care Medicine. Sleep Apnea and Cardiovascular Disease There are two kinds of sleep apnea and both are associated with heart disease. Central sleep apnea is the most common type found in heart failure patients and is probably caused by heart failure, says Dr. Bradley. During central sleep apnea, patients stop breathing and suffocate. The suffocation causes them to wake up and causes their heart muscle to jolt into action when it should be resting. The jolting action puts stress on the heart. These patients may, in fact, have developed the apnea following a heart attack, which usually is a contributing factor to heart failure. The second type of apnea is obstructive sleep apnea and it probably contributes to heart failure. This apnea is most common in overweight people who snore and have oversized necks. Muscle tone keeps the throat open during the day but at night the weight of the oversized neck narrows the airway and the tongue falls back and closes it. The person then struggles to breathe against the collapsed throat as if he/she were choking. The breathing efforts place an additional strain on the heart. Dr. Bradley has been studying sleep apnea and congestive heart failure for several years. In aprevious study he conducted, Dr. Bradley was the first to discover that patients with congestiveheart failure of unknown origin frequently suffered from obstructive sleep apnea as well. The study also concluded that a possible non-drug treatment is the use of CPAP. "Some of these patients were able to stop taking costly medications and stay off them,'' Dr. Bradley says. "With the use of CPAP, we were able to achieve complete normalization of their heart function in some cases.'' Dr. Bradley believes strongly that many heart failure patients have undiagnosed sleep apnea. These patients are taking costly medications and, in fact, may easily be treated with CPAP, Dr. Bradley says. "Heart failure is the single most common reason for hospital mortality.'' Dr. Bradley and patients who have recovered from heart failure following the use of CPAP are available for interviews. For further information: Josey Panetta, Senior Media Relations Officer, The Toronto Hospital, (416) 340-3303, aft c2290 r f BC-united-film-options 01-22 0183 News release via Canada NewsWire, Vancouver 604-669-7764 --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. 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