{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:09:06Z","timestamp":1785802146858,"version":"3.56.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T00:00:00Z","timestamp":1555718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"ReSMed Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pulmonary hypertension (PH) is extremely common in acute decompensated heart failure (ADHF) patients and predicts increased mortality. Obstructive sleep apnea (OSA), highly prevalent in congestive heart failure patients, may contribute to further elevated pulmonary pressures. This study evaluates the impact of positive airway pressure (PAP) therapy on PH in patients admitted for ADHF with OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A two-center randomized control trial comparing standard of care (SOC) therapy for ADHF versus addition of PAP therapy in patients with concomitant OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-one consecutive patients were enrolled with 1:1 randomization to SOC versus SOC plus 48-hour PAP therapy protocol. In the intervention arm, the mean pulmonary artery systolic pressure (PASP) difference before therapy and after 48 hours of PAP therapy was \u221215.8 \u00b1 3.2 (58.6 \u00b1 2.5 mm Hg to 42.8 \u00b1 2.7) versus the SOC arm where the mean PASP difference was \u22125.2 \u00b1 2.6 (62.7 \u00b1 3.3 mm Hg reduced to 57.5 \u00b1 3.9) (p = 0.025). In addition, ejection fraction in the intervention arm improved (3.4 \u00b1 1.5% versus \u22120.5 \u00b1 0.5 %) (p = 0.01). Significant improvement was also noted in tricuspid annular plane systolic excursion (TAPSE) and right ventricular systolic area in the intervention arm but not in NT-pro-BNP or 6-minute walk distance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with ADHF and OSA, addition of 48 hours of PAP therapy to SOC treatment significantly reduced PH. In addition, PAP therapy was able to improve right and left ventricular function.<\/jats:p><jats:p>ClinicalTrials.gov identifier: NCT02963597.<\/jats:p><\/jats:sec>","DOI":"10.1093\/sleep\/zsz100","type":"journal-article","created":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T06:33:04Z","timestamp":1555741984000},"source":"Crossref","is-referenced-by-count":42,"title":["Auto positive airway pressure therapy reduces pulmonary pressures in adults admitted for acute heart failure with pulmonary hypertension and obstructive sleep apnea. The ASAP-HF Pilot Trial"],"prefix":"10.1093","volume":"42","author":[{"given":"Sunil","family":"Sharma","sequence":"first","affiliation":[{"name":"Albert Einstein Medical Center, Sidney Kimmel Medical School, Philadelphia, PA"},{"name":"Division of Pulmonary , Critical Care, Sleep Medicine, West Virginia University, Morgantown, WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2187-8715","authenticated-orcid":false,"given":"Henrik","family":"Fox","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Aguilar","sequence":"additional","affiliation":[{"name":"Albert Einstein Medical Center, Sidney Kimmel Medical School, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umer","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"Albert Einstein Medical Center, Sidney Kimmel Medical School, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslee","family":"Willes","sequence":"additional","affiliation":[{"name":"Willes Consulting Group, Inc., Encinitas, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benham","family":"Bozorgnia","sequence":"additional","affiliation":[{"name":"Albert Einstein Medical Center, Sidney Kimmel Medical School, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bitter","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,20]]},"reference":[{"issue":"2","key":"2019070802254835400_CIT0001","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.hfc.2009.11.007","article-title":"Heart failure and pulmonary hypertension","volume":"6","author":"Shin","year":"2010","journal-title":"Heart Fail Clin."},{"issue":"12","key":"2019070802254835400_CIT0002","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1093\/eurheartj\/ehv512","article-title":"Left ventricular heart failure and pulmonary hypertension","volume":"37","author":"Rosenkranz","year":"2016","journal-title":"Eur Heart J."},{"issue":"12","key":"2019070802254835400_CIT0003","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1001\/jama.2013.2024","article-title":"Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial","volume":"309","author":"Redfield","year":"2013","journal-title":"J Am Med Assoc."},{"issue":"7","key":"2019070802254835400_CIT0004","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.jacc.2016.11.069","article-title":"Sleep apnea: types, mechanisms, and clinical cardiovascular consequences","volume":"69","author":"Javaheri","year":"2017","journal-title":"J Am Coll Cardiol."},{"key":"2019070802254835400_CIT0005","first-page":"2","article-title":"Positive airway pressure therapy for sleep disordered breathing in congestive heart failure is associated with reduction in pulmonary artery systolic pressure","volume":"5","author":"Tan","year":"2016","journal-title":"J Sleep Disor: Treat Care"},{"key":"2019070802254835400_CIT0006","first-page":"240","article-title":"2013 ACCF\/AHA Guideline for the Management of Heart Failure: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"128","author":"Yancy","year":"2013","journal-title":"Circulation"},{"issue":"27","key":"2019070802254835400_CIT0007","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J."},{"issue":"4","key":"2019070802254835400_CIT0008","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/ejechocard\/jeq031","article-title":"European Association of Echocardiography recommendations for the assessment of valvular regurgitation. 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