Abstract 9278: Adaptive Servo Ventilation Improves Cardiac Function and Prognosis in Heart Failure Patients With Cheyne-Stokes Respiration
Backgrounds: Cheyne-Stokes respiration (CSR) and central sleep apnea are often associated in patients with heart failure (HF). Although adaptive servo ventilation (ASV) is effective for CSR, it still remains unclear whether ASV improves cardiac function and prognosis of patients with HF and CSR.
Methods: Sixty patients with HF and CSR (mean age 61.0 years, mean ejection fraction 38.7%, mean apnea hypopnea index 36.8 times/hr, mean central apnea index 19.1 times/hr) were enrolled in this study. Patients were divided into two groups: 23 patients treated by conventional medications for HF with ASV (ASV group) and 37 patients treated by conventional medications without ASV (Non-ASV group). Plasma B-type natriuretic peptide (BNP) levels, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), LV mass index (LVMI) and left atrial volume index (LAVI) were determined before and 6 months after treatments in each group. Patients were followed up for cardiac events after discharge (cardiac death and rehospitalization due to worsening heart failure) with an average follow up period of 305 days.
Results: In ASV group, NYHA functional class (2.5 ± 0.6 to 1.6 ± 0.5, p<0.05), BNP (499.0 ± 580.2 to 191.6 ± 218.8 pg/ml, P<0.01), LVEF (38.3 ± 18.4 to 46.4 ± 15.4%, P<0.01), LVEDVI (84.7 ± 39.0 to 75.7 ± 34.8 ml/m2, P<0.05), LVESVI (56.3 ± 36.2 to 42.2 ± 26.8 ml/m2, P<0.05), LVMI (171.5 ± 70.7 to 153.5 ± 42.9 g/m2, P<0.05) and LAVI (52.3 ± 21.2 to 46.0 ± 20.0 ml/m2, P<0.05) were significantly improved with ASV treatment for 6 months. In contrast, any of these parameters did not change in Non-ASV group. Importantly, Kaplan-Meier analysis clearly demonstrated that event free rate was significantly higher in ASV group than in Non-ASV group (P<0.01 by logrank test).
Conclusions: Adaptive servo ventilation improved cardiac function and prognosis in heart failure patients with Cheyne-Stokes respiration.
- © 2010 by American Heart Association, Inc.