Abstract 11172: Adaptive Servo Ventilation Improves Cardio-renal Function and Prognosis in Heart Failure Patients With Chronic Kidney Disease and Sleep Disordered Breathing
Background: Association of chronic kidney disease (CKD) and sleep disordered breathing (SDB) play critical roles in the progression of heart failure (HF). It still remains unclear whether adaptive servo ventilation (ASV) improves cardio-renal function and long-term prognosis of HF patients with CKD and SDB.
Methods: Forty eight HF patients with CKD (defined as eGFR of < 60 ml/min/1.73cm2) and moderate-severe SDB (difined as apnea hypopnea index > 15 /h) were enrolled. Study subjects (mean LVEF 37.0%, mean eGFR 52.8 ml/min/1.73cm2, mean apnea hypopnea index 38.2 times/hr) were divided into two groups: 18 patients treated with conventional medications for HF and ASV (ASV group) and 30 patients treated with conventional medications alone (Non-ASV group). BNP, eGFR, and LVEF were measured before and 6 months after treatments. Patients were followed to register cardiac events (average follow up period 656 days).
Results: BNP, eGFR, and LVEF significantly improved in ASV group (BNP, 469.7 ± 420.4 to 198.2 ±156.4 pg/ml; eGFR, 55.5 ± 10.7 to 57.8 ± 15.6 ml/min/ 1.73cm2; LVEF, 36.6 ± 16.9 to 45.1 ± 15.2%, P<0.05, respectively), but any of these parameters did not change in Non-ASV group. Twenty-three events (death 11, re-hospitalization 12) ocurred in this follow up period. Importantly, event free rate was significantly higher in ASV group than in Non-ASV group (77.8% vs. 36.7%, logrank P<0.01).
Conclusions: ASV improved cardio-renal function and long-term prognosis in HF patients with CKD and SDB.
- © 2012 by American Heart Association, Inc.