Abstract 13531: Efficacy of Adaptive Servo Ventilation on the One-Year Prognosis in Patient with Heart Failure
Introduction: The Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure (CANPAP) study did not affect survival in patients who have central sleep apnea and heart failure. In recent years, adaptive servo ventilation (ASV) is used as a device for patients with heart faiure. However, it is unclear whether ASV therapy can improve survival in patients with heart faiure.
Hypothesis: We hypothesis that ASV therapy would improve the survival rate in patients heart failure.
Method: After medical therapy was optimized, we performed one-year follow-up study in 85 patients (mean age [±SD], 72 ± 10 years; 46 male patients, 39 female patients) with heart faiure which is categorized as NYHA class II-VI. The patients were classified into two groups based on adherence to ASV therapy. A group of patients using ASV > 4 hours/day was designated as the good compliance group. During follow-up, sleep studies were conducted and fatal cardiovascular events were checked.
Results: Fifty-seven patients were classified into the good compliance group. Before ASV therapy, there were no significant differences between the good compliance group and the poor compliance group in the ejection fraction level (the good compliance group, 41.5 ± 17.8% the poor compliance group, 41.1 ± 16.7% p = 0.925) and apnea hypopnea index (the good compliance group, 42.6 ± 25.7/hour; the poor compliance group, 36.4 ± 19.0/hour; p = 0.325), respectively. The good compliance group had significantly higher survival rate (Figure 1). In a Cox proportional hazards model, the odds ratio (95% confidence interval) of fatal cardiovascular events was 0.455 (0.235–0.811) for the good compliance group (p=0.0076), which was associated with a decreased risk of cardiovascular morbidity and mortality.
Conclusions: Our results suggest that appropriate use of ASV in patient with heart faiure affected survival, and may contribute to improve cardiovascular morbidity and mortality.
- © 2010 by American Heart Association, Inc.