无创通气对肥胖低通气综合征 (OHS) 患者心肌功能的慢性影响尚不清楚。本研究的目的是评估定向容量双水平气道正压通气（BiPAP）对 OHS 患者心脏参数和心肌生物标志物的长期影响。临床稳定的 OHS 患者转诊至三级中心启动的长期 BiPAP 治疗连续入组。在基线时，所有参与者均接受过夜心肺多图检查。开始使用通过口鼻罩递送的定向容量自发/定时模式的 BiPAP 治疗。通过阻抗心动图进行逐搏无创监测用于评估基线以及使用 BiPAP 3 个月和 12 个月后的心功能。监测血清肌钙蛋白 1、N 端 B 型利钠肽 (NT-ProBNP)、肿瘤坏死因子-α (TNF-α) 和白细胞介素 6 (IL-6)。 13 名患者（10 名男性；平均招募的年龄为 55.8 ± 9.8 岁；平均体重指数为 47.8 ± 5.9 kg/m2。从基线到使用 BiPAP 3 个月和 12 个月，左心室每搏输出量 (SV)、射血时间 (LVET) 和射血时间指数显着增加（分别为 P = 0.030；P < 0.001；P = 0.003），而心率和收缩时间比显着下降（分别为 P = 0.004；P = 0.034）。观察到血清 NT-proBNP、IL-6 和 TNF-α 降低（分别为 P = 0.045；P = 0.018；P = 0.003）。在整个研究过程中，未检测到血清肌钙蛋白的显着变化。目前发现，稳定型 OHS 和慢性中度至重度白天患者的 SV 增加与 LVET 延长、NT-proBNP 减少和循环炎症标志物减少相关使用 BiPAP 治疗一年以上的高碳酸血症支持了这种治疗模式在此类患者中的作用。版权所有 © 2024。由 Elsevier Ltd 出版。

Chronic effects of noninvasive ventilation on myocardial function in patients with obesity hypoventilation syndrome (OHS) are scarcely understood. The aim of the present study was to evaluate the long-term effects of volume-targeted bilevel positive airway pressure ventilation (BiPAP) on cardiac parameters and myocardial biomarkers in patients with OHS.Clinically stable patients with OHS referred to the tertiary center for the initiation of long-term BiPAP therapy were consecutively enrolled. At baseline, all participants underwent overnight cardiorespiratory polygraphy. BiPAP therapy using volume-targeted spontaneous/timed mode delivered via an oro-nasal mask was initiated. Beat-to-beat noninvasive monitoring by impedance cardiography was used to assess heart function at baseline and after 3 and 12 months of BiPAP use. Serum troponin 1, N-Terminal Pro-B-Type Natriuretic Peptide (NT-ProBNP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were monitored.Thirteen patients (10 men; mean age, 55.8 ± 9.8 years; mean body mass index of 47.8 ± 5.9 kg/m2) were recruited. From baseline to 3, and to 12 months of BiPAP use, left ventricular stroke volume (SV), ejection time (LVET), and ejection time index significantly increased (P = 0.030; P < 0.001; P = 0.003, respectively), while heart rate and systolic time ratio significantly decreased (P = 0.004; P = 0.034, respectively). Reductions in serum NT-proBNP, IL-6 and TNF-α were observed (P = 0.045; P = 0.018; P = 0.003, respectively). No significant changes in serum troponin were detected throughout the study.The present findings of increased SV, in association with lengthening of LVET, reductions of NT-proBNP and reductions in circulatory inflammatory markers in patients with stable OHS and chronic moderate-to-severe daytime hypercapnia treated with BiPAP over 1 year support the role of this therapeutic mode in such patients.Copyright © 2024. Published by Elsevier Ltd.