Abstract 10099: Adaptive Servo-ventilation Therapy Improves Long-term Prognosis in Heart Failure Patients With Anemia and Sleep-disordered Breathing
Backgrounds: Sleep-disordered breathing (SDB) influences the progression of chronic heart failure (CHF), and adaptive servo ventilation (ASV) is an effective therapeutic device for SDB. Anemia is also associated with increased mortality and morbidity in CHF patients. However, the prognostic impacts of ASV for CHF patients with or without anemia have been unclear.
Methods: One hundred and thirty nine patients with CHF and SDB were divided into two groups: those treated with ASV (n=53) and without ASV (n=86). All patients were prospectively followed after discharge during a mean follow-up period of 603 days with the end points of cardiac death or progressive heart failure requiring rehospitalization. Anemia was defined as hemoglobin level <13.2 g/dl for men and <11.6 g/dl for women.
Results: There were 65 patients (47%) with anemia in all subjects. Apnea hypopnea index (AHI) was improved after ASV in both groups (P<0.001). Although ASV decreased plasma B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein levels in the anemia group (P=0.0039 and P=0.0036, respectively) and in the non-anemia group (P=0.0500 and P=0.0022, respectively), these changes were not observed in patients treated without ASV. The Kaplan-Meier survival curve demonstrated that cardiac event-free rate was significantly higher in CHF patients treated with ASV than those without ASV (68.6% vs. 33.1%, P=0.008) in the anemia group. However, in the non-anemia group, cardiac event free rate was similarly high in patients both with and without ASV (80.0% vs. 77.6%, P=0.664). The multivariate Cox proportional hazard analysis demonstrated that ASV use was the independent predictor of cardiac event in the anemia group (hazard ratio 0.346, 95% confidence interval 0.132-0.907, P=0.0308), but not in the non-anemia group.
Conclusions: These results revealed that ASV treatment for CHF and SDB was more effective in patients with anemia than in those without anemia.
- © 2013 by American Heart Association, Inc.