Abstract 13604: Integrated Area of Desaturation Index can Predict Three-Year Prognosis in Heart Failure Patients after Adaptive Servo Ventilation Therapy
Introduction: Adaptive servo ventilation (ASV) is used as a device for patients with heart failure. Previously, we reported that Integrated Area of Desaturation Index (IAD index) can estimate the efficacy of ASV therapy in acute phase. However, it is unclear that IAD index can estimate long-term prognosis after ASV therapy.
Hypothesis: We hypothesize that IAD index can predict long-term prognosis after ASV therapy.
Methods: The study group consisted of 57 HF patients. The mean age was 70 ± 11 years. After treating the underlying disease in the acute phase, patients were treated with ASV. To estimate short-term effects, we established the association between changes in brain natriuretic peptide ([[Unable to Display Character: ⊿]]BNP) and left ventricular ejection fraction ([[Unable to Display Character: ⊿]]LVEF). We also estimate several polysomnographic parameters including IAD index, which is new measurement for assessing the severity of sleep apnea, which is obtained by integrating nocturnal desaturation area before and after ASV therapy. After dividing into two groups using IAD index after ASV therapy (Group H: IAD index >25%sec/min, Group L: IAD index<25%sec/min), we observed three-year follow-up data including fatal cardiovascular events (death from progressive HF, cardioembolic stroke, and fatal cardiac arrhythmias) to estimate long-term effects.
Results: After ASV therapy, IAD index showed significant improvement as a whole (Before ASV therapy: 71.2 ± 59.2%sec/min, After ASV therapy: 36.7 ± 30.8%sec/min). [[Unable to Display Character: ⊿]]BNP (Group H: -291 ± 425pg/ml, Group L: -356 ± 707pg/ml, p = 0.67) and [[Unable to Display Character: ⊿]]LVEF (Group H: 9.1 ± 10.8%, Group L: 8.0 ± 11.8%, p = 0.73) equally showed improvement in both groups. On the other hand, three-year follow-up data showed that group H was associated with a significantly increased risk for fatal cardiovascular events (Group H: 32.4%, Group L: 5.0%, p = 0.01).
Conclusions: Our results suggest that IAD index after ASV therapy can predict long-term prognosis in heart failure patients.
Author Disclosures: N. Takama: None. H. Hasegawa: None. K. Goto: None. K. Masuda: None. H. Sorimachi: None. M. Sato: None. M. Obokata: None. Y. Matsuo: None. H. Sano: None. R. Funada: None. S. Kasama: None. N. Koitabashi: None. M. Kurabayashi: None.
- © 2014 by American Heart Association, Inc.