Abstract 11007: Three Months Treatment with Adaptive Servo-Ventilation Improves Cardiac Function and Physical Activity in Patients with Chronic Heart Failure and Cheyne-Stokes Respiration in a Prospective Randomized Controlled Trial
Background: Cheyne-Stokes respiration (CSR), is a sleep disordered breathing frequently occurring in patients with congestive heart failure (CHF). CSR causes repetitive episodes of hypoxia and arousal from sleep, leading to sympathetic activation, fatigue and excessive daytime sleepiness. Adaptive servo-ventilation (ASV) is a novel therapy shown to be more effective in reducing CSR than Continuous Positive Airway Pressure-machine and nasal oxygen in CHF patents with CSR. The aim of this study was to investigate the effects of ASV on CHF parameters in a prospective randomized controlled trial.
Methodes: 51 patients (age 57-81, 4 women), New York Heart Association(NYHA) functional class III or IV, despite optimal cardiac medication, and/or left ventricular ejection fraction (LVEF) ≤ 40% and CSR more than 25% of sleeping time were randomized to either treatment with ASV or as a control group. Thirty patients completed the study, 15 in each group. Primary end point was any changes in LVEF from baseline to 3 months. Secondary end points were alterations in physical capacity by six-minutes walk test and NYHA class.
Results: At baseline, there were no statistical differences between the 2 groups regarding LVEF, NYHA and six-minutes walk test. In the ASV treatment group LVEF significantly improved from baseline (32±11%) to study end at 3 months (36±13%, p=0.004). Six-minutes walk test improved from 377±115m to 430±123m (p=0.001) and NYHA class improved from 3.2±0.4 to 2.3±0.6 (p<0.001). In the control group there were no significant changes in any parameter after 3 months.
Conclusion: These results suggest that CHF patients with CSR might benefit from treatment with ASV supplemental to standard medication.
- © 2011 by American Heart Association, Inc.