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Abstract: Background: Obstructive sleep apnoea (OSA) has the potential to cause heart failure. We aimed to determine the effects of nasal continuous positive airway pressure (CPAP) therapy on left ventricular structure and myocardial performance index (MPI) in severe OSA patients. Methods: Sixty-seven subjects without any cardiac or pulmonary disease had overnight polysomnography and echocardiography. In 33 males with severe OSA, thickness of interventricular septum (IVS) and posterior wall (LVPW) were measured by M-mode. Left ventricular MPI was calculated as (isovolumic contraction time+isovolumic relaxation time)/aortic ejection time by Doppler. Results: Eight males were non-compliant with CPAP. Mean age was 47.9±8.2 years, and 20 of 25 patients (80.0%) were hypertensive. Patients had high body mass index (BMI: 31.0±3.9kg/m2), but there was no change in BMI from baseline after 6 months. Thickness of IVS (11.0±1.1mm) and LVPW (11.0±1.0mm) at baseline were significantly decreased after 6 months of CPAP therapy (10.5±0.9mm, P <0.001 and 10.4±0.7mm, P <0.0001, respectively). Left ventricular MPI (60.1±13.8%) significantly decreased (53.0±10.7%, P <0.0001) after CPAP usage. Conclusions: In male patients with severe OSA, CPAP therapy significantly decreases left ventricular wall thickness and improves global function even with 6 months of usage. [Copyright &y& Elsevier]

Objectives: Obstructive sleep apnoea (OSA) might cause right ventricular dysfunction and pulmonary hypertension. We aimed to determine the effects of nasal continuous positive airway pressure (CPAP) therapy on right ventricular myocardial performance index (MPI) in OSA patients without hypertension. Methods: 49 subjects without hypertension, diabetes mellitus, any cardiac and pulmonary disease had overnight polysomnography and echocardiography. In 18 moderate-severe OSA (apneahypopnea index ≥ 15) patients, right ventricular free wall diameter (RVFWD) was measured by Mmode,and right ventricular MPI was calculated as (isovolumic contraction time+ isovolumic relaxation time) / pulmonary ejection time using Doppler at baseline and after 6 months CPAP therapy. Results: Mean age was 46.5 ± 4.9 year. Patients had high body mass index (BMI: 30.6 ± 4,0 kg/m²), but there was no change in either BMI or blood pressures after 6 months. Right ventricular enddiastolic and end-systolic diameters were in normal limits at baseline, and did not change after CPAP usage. Baseline RVFWD (7.1 ± 2.1 mm) significantly decreased after CPAP therapy (6.2 ± 1.7 mm, p < 0.001). 15 of patients (83%) had right ventricular diastolic dysfunction at baseline, and it was completely improved in 11 of them (73%) by CPAP usage. Right ventricular global dysfunction was shown in 11 patients (61%) with a high MPI (62.2 ± 9.3%) at baseline; and MPI was significantly decreased after CPAP therapy (47.3 ± 8.4%, p < 0.0001), and it was completely corrected in 4 of them (36%). Conclusion: CPAP therapy significantly decreases RVFWD and improves right ventricular diastolic and global functions (MPI) in OSA patients without hypertension. [ABSTRACT FROM AUTHOR]

Alveolar hemorrhage (AH), which is caused by a group of heterogeneous disorders, is clinically characterized by dyspnea and hemoptysis; diffuse, bilateral alveolar infiltrates on chest radiograph; and anemia. One should get suspicious of this diagnosis when the patient has dyspnea, hemoptysis, increased alveolar-arterial oxygen gradient, and diffuse alveolar infiltrates on chest radiograph. Treatment is based on plasmapheresis, steroids, and cyclophosphamide. AH is a rare but life threatening situation. Making right differential diagnosis and beginning appropriate early therapy has utmost importance in life saving. In this article, we will present 3 patients with AH with their clinics, response to therapies and prognosis. [ABSTRACT FROM AUTHOR]