title: First experience of using new adaptive servo-ventilation device for Cheyne-Stokes respiration with central sleep apnea among Japanese patients with congestive heart failure: report of 4 clinical cases.
abstract: BACKGROUND
  Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) in congestive heart failure (CHF) is generally considered a poor prognostic indicator, but treatment of CSR-CSA using an adaptive servo-ventilation (ASV) device has been developed. This is the first evaluation of its use in the management of CSR-CSA in Japanese CHF patients.
  
  
  RESULTS
  Four CHF patients with CSR-CSA that was unresponsive to conventional positive airway pressure (CPAP) underwent 3 nights of polysomnography: baseline, CPAP or bi-level PAP, and on the ASV. The apnea - hypopnea index (AHI) and central-AHI (CAHI) were markedly improved on ASV (AHI 62.7+/-10.1 to 5.9+/-2.2 /h, p=0.0006, CAHI 54.5+/-6.7 to 5.6+/-2.3 /h, p=0.007). In addition, the sleep quality improved significantly on ASV, including arousal index (62.0+/-10.5 to 18.7 +/-6.2 /h, p=0.012), percentage of slow-wave sleep (2.6+/-2.6 to 19.4+/-4.8 %, p=0.042).
  
  
  CONCLUSIONS
  ASV markedly improved CSR-CSA in patients with CHF. It is a promising treatment for Japanese patients with CHF.
authors.affiliation: Sleep Center, Toranomon Hospital, Japan. kasai-t@mx6.nisiq.net
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Takaya
authors.forename: Naotake
authors.initials: N
authors.lastname: Yanagisawa
authors.forename: George
authors.initials: G
authors.lastname: Dungan
authors.forename: Sugao
authors.initials: S
authors.lastname: Ishiwata
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohno
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ymaguchi
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002639:Cheyne-Stokes Respiration / Q000150:complications / Q000628:therapy*; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D007564:Japan; D008297:Male; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods; D020182:Sleep Apnea, Central / Q000150:complications / Q000628:therapy*; D012122:Ventilators, Mechanical