Heart Failure, Congestive Clinical Trial
Official title:
Evaluation of the Effects of Intra-thoracic Positive Pressure Applicated With CPAP (Continuous Positive Airway Pressure) on Ventricular Function in Patients With Chronic Heart Failure: Modification Induced on Baroreflex Sensitivity
To assess modifications of ventricular function induced by CPAP (Continuous Positive Airway Pressure).
There are still few studies on the effects of positive intra-thoracic pressure on
ventricular function and spontaneous baroreflex sensitivity changes. Aim of the study is to
evaluate, in patients with chronic heart failure with an ejection fraction < 40%, the
modifications of ventricular function induced by CPAP (Continuos Positive Airway Pressure)
application. All the measurament will be made in basal condition (without CPAP) and with
CPAP administration at 10 cmH2O via an oro-nasal mask.
Echocardiograpich evaluation: morphologic and hemodynamic evaluation is obtained with an
echocardiographic exmination. Left ventricular measurement will be assessed in M-mode, under
two dimensional guide) according to American Society of Echocardiography guidelines. Left
ventricular ejection fraction will be assessed with Simpson method.
Right ventricle morphology will be evaluated categorizing dimensions in a) normal, b) mild
enlargement, c) severely increased and d) reduced. Right ventricle area will also be
quantified in tele-diastole and in meso-sistole in apical 4 chamber and parasternal
short-axis.
Baroreflex control of heart rate was assessed by "sequence method" analysis of continuous
blood pressure recordings obtained in basal condition and during CPAP. Data obtained by non
invasive assessment of arterial pressure will be analized and values of arterial systolic,
diastolic pressure and pulsatory period for each cardiac cicle will be registered.
Assessment via "sequence method" is founded on identification, every 10 minutes, on
sequences characterized by a progressive increase both in pressure both in RR interval or,
conversely, by a progressive reduction of pressure and RR interval evaluated on 4 or more
cardiac cicles.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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