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Title EXPLORING THE USE OF MANDIBULAR ADVANCEMENT DEVICE AS AN OBSTRUCTIVE SLEEP APNEA THERAPY IN ASIAN PATIENTS WITH HEART FAILURE |
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Type Free Paper Session 2 |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Heart Failure / Cardiovascular Rehabilitation & Preventive Cardiology |
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Main Author Mahashne M1 |
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Presenting Author Mahashne M1 |
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Co-Author Juliana Colpani2 Aye Thandar Aung3 Venesa Loh3 Peiqing Xu3 Mei Teng Ong2 Weiqiang Loke2 Chi-Hang Lee1 |
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Department / Institution / Country Cardiology / National University Hospital / Singapore1 Faculty of Dentistry / National University Health System / Singapore2 Medicine / National University of Singapore / Singapore3 |
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Objective(s) Obstructive Sleep Apnea (OSA) is associated with Heart Failure (HF). CPAP is the first-line treatment, but it is limited by low adherence. Mandibular Advancement Device (MAD) is an approved alternative. It works by protruding the mandible forward during sleep. We assessed the impact of MAD on Apnea-Hypopnea Index (AHI) in 100 Asian patients with HF with reduced Ejection Fraction (HFrEF) and OSA. |
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Material and Method This was a randomized, double-blind, placebo-controlled, cross-over trial. Eligible patients underwent polysomnography. Patients found to have OSA with AHI of ≥ 15 events/hr were randomized to (i) MAD followed by sham MAD (non-advanced device) or (ii) sham MAD followed by MAD. Each treatment mode lasted for 4 months (1-month acclimatization + 3-months of treatment) with a 2-week washout period in between. Polysomnography, Echocardiography, and biomarker evaluations were performed at the baseline, 5-month, and 9.5-month follow-up. |
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Result(s) As of 22nd February 2019, 15 patients (14 male) were recruited with mean age 55 ± 8. Baseline polysomnography showed 5 patients (56%) had severe OSA (AHI ≥ 30), 2 patients (22%) had moderate OSA (AHI 15 - <30), 1 patient (11%) had mild OSA (AHI 5 - <15) and 1 patient (11%) did not have OSA (AHI < 5). 1 patient has completed the study. 1 patient has completed phase one and, is in the acclimatization period of phase two. 2 patients are in phase one.1 patient is in the acclimatization period of phase one. 2 patients have completed baseline polysomnography but have not started wearing the MAD. 2 patients' had AHI < 15 and did not continue after the baseline polysomnography. 6 patients have not done the baseline polysomnography. More data will be presented in the future. |
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Conclusion If MAD is found to be effective, it could serve as a viable alternative therapy for OSA in Asian Patients with HF. |