Journal Article

Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne–Stokes respiration

Olaf Oldenburg, Anke Schmidt, Barbara Lamp, Thomas Bitter, Bogdan G. Muntean, Christoph Langer and Dieter Horstkotte

in European Journal of Heart Failure

Published on behalf of European Society of Cardiology

Volume 10, issue 6, pages 581-586
Published in print June 2008 | ISSN: 1388-9842
Published online June 2008 | e-ISSN: 1879-0844 | DOI: http://dx.doi.org/10.1016/j.ejheart.2008.04.007
Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne–Stokes respiration

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Background and aims

Sleep disordered breathing (SDB), especially Cheyne–Stokes respiration (CSR) is common in patients with chronic heart failure (CHF). Adaptive servoventilation (ASV) was recently introduced to treat CSR in CHF. The aim of this study was to investigate the effects of ASV on CSR and CHF parameters.

Methods

In 29 male patients (63.9±9 years, NYHA≥II, left ventricular ejection fraction [LV-EF]≤40%), cardiorespiratory polygraphy, cardiopulmonary exercise (CPX) testing, and echocardiography were performed and concentrations of NT-proBNP determined before and after 5.8±3.5 months (median 5.7 months) of ASV (AutoSet CS™2, ResMed) treatment. All patients also received guideline-driven CHF therapy.

Results

Apnoea–hypopnoea-index was reduced from 37.4±9.4/h to 3.9±4.1/h (p<0.001). Workload during CPX testing increased from 81±26 to 100±31 W (p=0.005), oxygen uptake (VO2) at the anaerobic threshold from 12.6±3 to 15.3±4 ml/kg/min (p=0.01) and predicted peak VO2 from 58±12% to 69±17% (p=0.007). LV-EF increased from 28.2±7% to 35.2±11% (p=0.001), and NT-proBNP levels decreased significantly (2285±2192 pg/ml to 1061±1293 pg/ml, p=0.01).

Conclusions

In selected patients with CHF and CSR, addition of ASV to standard heart failure therapy is able to improve SDB, CPX test results, LV-EF and NT-proBNP concentrations.

Keywords: Adaptive servoventilation; Chronic heart failure; Cheyne–Stokes respiration; Sleep disordered breathing

Journal Article.  3897 words. 

Subjects: Cardiovascular Medicine

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