title: Beneficial effects of adaptive servo ventilation in patients with chronic heart failure.
abstract: BACKGROUND
  Sleep-disordered breathing (SDB) is thought to be a state of inflammation caused by hypoxic stress. Whether adaptive servo ventilation (ASV) attenuates the inflammatory response and improves the cardiac function of patients with congestive heart failure (CHF) accompanied by SDB was not been investigated.
  
  
  RESULTS
  Seventeen inpatients with New York Heart Association (NYHA) II or III underwent polysomnography. There was a positive correlation between the apnea hypopnea index and high-sensitivity C-reactive protein (hs-CRP) level (r=0.753, P=0.016). The patients were divided into ASV (n=10) and non-ASV groups (n=7), and CHF-parameters were measured before and after ASV treatment. Improvement was noted for the NYHA class in the ASV group but not in the non-ASV group. In contrast to the non-ASV group, the level of brain natriuretic peptide (BNP), ejection fraction, and hs-CRP levels in the ASV group significantly improved (BNP, 212.1 ± 181.2 to 77.3 ± 54.0 pg/ml [P<0.05]; ejection fraction, 43.5 ± 6.4 to 53.3 ± 6.1% [P=0.002]; hs-CRP, 0.85 ± 0.58 to 0.21 ± 0.19 mg/dl, [P=0.008]). The increase in ejection fraction was correlated with a decrease in the hs-CRP level (r=-0.753, P=0.001).
  
  
  CONCLUSIONS
  Anti-inflammatory effects of ASV are important contributors for improving cardiac function in patients with CHF accompanied by SDB.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kobukai
authors.forename: Shin
authors.initials: S
authors.lastname: Makabe
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Munehisa
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D017286:Polysomnography; D011175:Positive-Pressure Respiration; D012891:Sleep Apnea Syndromes / Q000151:congenital* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein