CPAP Therapy in Patients With Heart Failure and Obstructive Sleep Apnea.

Summary

Heart failure affects approximately 5-6 million North Americans and is increasing in prevalence. Sleep-related disorders, such as obstructive sleep apnea (OSA) often coexist (11-37% incidence) with heart failure. OSA is the repeated temporary interruption of breathing during sleep and occurs when the air passages in the upper respiratory tract become blocked during sleep. OSA adversely affects the cardiovascular system resulting in hypoxia (decrease in oxygen supply), which decreases the oxygen supply to the heart. Patients with OSA are treated with continuous positive airway pressure (CPAP). It has also been shown that CPAP reduces angina during sleep, minimizes sympathetic nervous system (SNS) activation and improves left ventricular (LV) function, although the mechanism of action is not clear. Carbon-11 acetate PET imaging allows for the assessment of how the heart works and how efficiently the heart uses oxygen in certain circumstances. Carbon-11 hydroxyephedrine (HED) measures cardiac nervous system activity, which may have an effect on heart rate. The study will evaluate the term effects of continuous positive airway pressure (CPAP), a common treatment for patients with OSA, on the heart's efficiency or ability to work and its effect on the nervous system activity of the heart. Two patient groups will be evaluated 1.) patients with congestive heart failure and obstructive sleep apnea will be randomized to early or late CPAP to address the primary hypothesis of the study and 2.) patients with congestive heart failure only (matched control group). Both the primary randomized study group and secondary study group will be evaluated using \[11C\]acetate PET, \[11C\]HED PET and echocardiography. Measurements will be obtained at baseline, 1 week (where possible) and 6-8 weeks.

Conditions

• Heart Failure
• Obstructive Sleep Apnea

Interventions

OTHER

Positron Emission Tomography

PET imaging at baseline, 1 week and 6-8 weeks. CPAP begins after baseline PET scan.

OTHER

Positron Emission Tomography

PET imaging at Baseline, 1 week and 6-8 weeks. CPAP begins after 6-8 week PET scan.

OTHER

Positron Emission Tomography

PET scan at baseline and 6-8 weeks, no CPAP therapy

Sponsors & Collaborators

• Heart and Stroke Foundation of Ontario

  collaborator OTHER

• Ottawa Heart Institute Research Corporation

  lead OTHER

Principal Investigators

• Rob S Beanlands, MD, FRCP C · Ottawa Heart Institute Research Corporation

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2005-07-31

Primary Completion

2011-06-30

Completion

2011-12-31

Countries

• Canada

Study Locations