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ABSTRACT: It has been known for a long time that obstructive sleep apnea (OSA) is associated with a decreased left ventricular ejection fraction (LVEF). Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA; however, it is unknown whether or not CPAP treatment will improve the LVEF. The aim of the current study was to assess whether or not CPAP treatment improves the LVEF. A meta-analysis was conducted to determine the effect of CPAP treatment on the LVEF among patients with OSA.
A literature search of PubMed, the Web of Science, and Cochrane Collaboration's database were utilized to identify eligible reports for this trial. Ten randomized controlled trails were examined and the meta-analysis was performed using STATA 11.
A significant improvement in the LVEF was observed after CPAP treatment (weighted mean difference(WMD) = 3.59, 95% CI = 1.74-5.44; P<0.001). Subgroup analysis revealed that patients with OSA and heart failure had a significant improvement in the LVEF after CPAP treatment (WMD = 5.18, 95% CI = 3.27-7.08; P<0.001); however, the LVEF of patients with OSA only increased 1.11% and there was no statistical significance (WMD = 1.11, 95% CI = -1.13-3.35; P = 0.331). Furthermore, based on univariate meta-regression analysis, only the baseline AHI had a statistically significant correlation with the LVEF.
Our meta-analysis supports the notion that CPAP may improve the LVEF among patients with OSA.
PLoS ONE 01/2013; 8(5):e62298. · 4.09 Impact Factor
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ABSTRACT: Studies have suggested that subclinical hypothyroidism (SCH) may have detrimental effects on left ventricular (LV) diastolic function. Whether SCH is a risk factor for LV diastolic dysfunction is controversial. Databases (MEDLINE, PubMed, EMBASE) were searched for cross-sectional studies evaluating LV diastolic function in SCH patients aged <60 years using tissue Doppler echocardiography (TDE) and conventional two-dimensional Doppler echocardiography (2D-DECG) published in the past 12 years. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed or random-effects models. We summarized the results of 14 cross-sectional studies with 675 participants. SCH patients had a significantly lower LV mitral annular E(a) peak velocity (WMD=-1.71cm/s; 95%CI: -3.02 to -0.40; p<0.05), E(a)/A(a) ratio (WMD=-0.22; 95%CI: -0.40 to -0.05; p<0.05), and significantly higher mitral annular A(a) peak velocity (WMD=0.47cm/s; 95%CI: 0.10-0.85; p<0.05) than euthyroid subjects using TDE. Subgroup analyses showed that statistical significance existed only in E(a) and E(a)/A(a) parameters when data from "women≥90%" were used, and in the A(a) parameter when data from "women<90%" were used. No matter which subgroup of females was used, there were significant differences in LV peak transmitral A velocity (WMD=7.64cm/s; 95%CI: 4.55-10.73; p<0.05), and E/A ratio (WMD=-0.22; 95%CI: -0.31 to -0.21; p<0.05) but no significant difference in peak transmitral E velocity (p>0.05) between SCH patients and euthyroid controls using 2D-DECG. Therefore, for those aged <60 years, SCH patients had significantly worse parameters of LV diastolic function than euthyroid controls.
Journal of Cardiology 10/2012; · 1.28 Impact Factor
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ABSTRACT: To explore the association between subclinical hypothyroidism and the left ventricular functions under conventional 2D Doppler echocardiography and to provide evidence for the protection of heart function.
Literatures regarding the association of subclinical hypothyroidism and the left ventricular functions were retrieved in large databases from home and abroad for the last 12 years. The left ventricular systolic function was assessed by left ventricular ejection fraction and the shortening of left ventricular fraction. The left ventricular diastolic function was assessed by left ventricular early diastolic filling flow velocity, late diastolic filling flow velocity, their ratios (E/A), and the left ventricular isovolumic relaxation time. The relationship between subclinical hypothyroidism and the left ventricular functions were assessed by Meta-analysis with Stata 11 software. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, and the publication bias was assessed by Begg's test.
13 eligible papers were included. (1) Statistics on the combined data showed that in the evaluation of left ventricular diastolic function indicators. There were significant differences in left ventricular late diastolic filling flow velocity (WMD = 4.51, 95%CI: 2.41 to 6.61) and E/A (WMD = -0.22, 95%CI: -0.30 to -0.13), as well as the left ventricular isovolumic relaxation time (WMD = 6.13, 95%CI: 2.79 to 9.48) between patients with subclinical hypothyroidism and normal controls but, no significant difference was found in left ventricular early diastolic filling flow velocity. Looking at the left ventricular systolic function indicators. There were no significant differences in the left ventricular ejection fraction and left ventricular fractional shortening between patients with subclinical hypothyroidism and normal controls. (2) Data from the subgroup analysis showed that the differences of left ventricular late diastolic filling flow velocity, E/A and left ventricular isovolumic relaxation time were significantly different between patients with subclinical hypothyroidism and normal controls in the mean heart rate ≥ 72 bpm group. The difference of left ventricular isovolumic relaxation time was significantly different in the mean heart rate < 72 bpm group, and the difference of left ventricular late diastolic filling flow velocity was significant in the mean age < 60-year-old group.
Subclinical hypothyroidism was associated with the left ventricular diastolic dysfunction, but not associated with the left ventricular systolic dysfunction. The results suggested that subclinical hypothyroidism might change the heart function which could be evaluated by Doppler echocardiography.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 12/2011; 32(12):1269-74.
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ABSTRACT: This study was to compare the retention of posts fabricated by different methods and cemented with various cements in order to provide a guidance for clinical choice of post fabrication methods and luting cements.
Ninety human maxillary anterior teeth were sectioned by the cementoenamel junction and post-holes were prepared. All roots were embedded in the center of plastic cylinders and paralleled with the cylinder. All samples were divided into 9 groups randomly and equally. Posts fabricated with different methods were then cemented with different luting cements. Each sample was placed into a specialized jig and mounted on a tensile testing machine with crosshead speed of 5 mm/min. Constant tensile force was applied until the post was dislodged, and the tensile force required to dislodge the cemented post was recorded.
The mean retention force of parapost and direct post demonstrated significantly higher than that of indirect post did (P < 0.05), but there was no significant difference between parapost and direct post(P > 0.05). The mean retention of parapost cement demonstrated significantly higher than that of ZPC and HY-Bond cement did (P < 0.05), but there was no significant difference between ZPC and HY-Bond cement (P > 0.05).
Different fabrication methods and luting cements significantly affect the retention of posts; and there exists an interaction between different fabricating methods and luting cements.
Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology 04/2004; 22(2):152-4.
