Effect of Continuous Positive Airway Pressure on Left Atrial Volume Index in Patients With Stroke and Obstructive Sleep Apnea: A Randomized Trial.
Chou-Han Lin, Shan-Hui Huang, Yu Cheng Chu et al.
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In 30 seconds
This randomized trial evaluated whether continuous positive airway pressure (CPAP) altered left atrial volume index (LAVI) in patients with stroke and obstructive sleep apnea. Seventy-one participants received standard care plus CPAP or standard care alone, with cardiac and functional outcomes assessed through 12 months. CPAP did not significantly reduce 12-month LAVI versus control: the between-group difference in change was 0.5 mL/m² (95% CI, -3.2 to 4.1 mL/m²; P=0.804). LAVI trajectories nevertheless differed over time, and complete neurologic recovery at 12 months was more frequent with CPAP.
Key findings
- The between-group difference in 12-month LAVI change was 0.5 mL/m² (95% CI, -3.2 to 4.1 mL/m²; P=0.804), not statistically significant.
- LAVI showed a significant group-by-time interaction (P=0.005); among follow-up completers, trajectories diverged after 6 months (P=0.020).
- At 12 months, modified Rankin Scale score 0 occurred in 46.9% with CPAP versus 22.6% with control (P=0.043).
- NT-proBNP declined in the CPAP group (P=0.029), but there was no between-group difference.
Why it matters
The trial separates the absence of a significant 12-month difference in LAVI from signals in longitudinal cardiac measurements and functional recovery. These findings are relevant to understanding whether treating obstructive sleep apnea after stroke may affect cardiac markers and neurologic outcomes, while the primary between-group LAVI result does not establish a reduction in atrial volume.
What to keep in mind
The trial randomized 71 participants, and the trajectory and recovery findings were reported among the 63 participants who completed follow-up; the abstract does not provide further detail on follow-up duration beyond 12 months.