title: Adaptive servoventilation improves cardiac function and respiratory stability.
abstract: Cheyne-Stokes respiration (CSR) in patients with chronic heart failure (CHF) is of major prognostic impact and expresses respiratory instability. Other parameters are daytime pCO₂, VE/VCO₂-slope during exercise, exertional oscillatory ventilation (EOV), and increased sensitivity of central CO₂ receptors. Adaptive servoventilation (ASV) was introduced to specifically treat CSR in CHF. Aim of this study was to investigate ASV effects on CSR, cardiac function, and respiratory stability. A total of 105 patients with CHF (NYHA ≥ II, left ventricular ejection fraction (EF) ≤ 40%) and CSR (apnoea-hypopnoea index ≥ 15/h) met inclusion criteria. According to adherence to ASV treatment (follow-up of 6.7 ± 3.2 months) this group was divided into controls (rejection of ASV treatment or usage <50% of nights possible and/or <4 h/night; n = 59) and ASV (n = 56) adhered patients. In the ASV group, ventilator therapy was able to effectively treat CSR. In contrast to controls, NYHA class, EF, oxygen uptake, 6-min walking distance, and NT-proBNP improved significantly. Moreover, exclusively in these patients pCO₂, VE/VCO₂-slope during exercise, EOV, and central CO₂ receptor sensitivity improved. In CHF patients with CSR, ASV might be able to improve parameters of SDB, cardiac function, and respiratory stability.
authors.affiliation: Department of Cardiology, Heart and Diabetes Centre North Rhine Westphalia, University Hospital, Ruhr University Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de
authors.forename: Olaf
authors.initials: O
authors.lastname: Oldenburg
authors.forename: Thomas
authors.initials: T
authors.lastname: Bitter
authors.forename: Roman
authors.initials: R
authors.lastname: Lehmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Korte
authors.forename: Zisis
authors.initials: Z
authors.lastname: Dimitriadis
authors.forename: Lothar
authors.initials: L
authors.lastname: Faber
authors.forename: Anke
authors.initials: A
authors.lastname: Schmidt
authors.forename: Nina
authors.initials: N
authors.lastname: Westerheide
authors.forename: Dieter
authors.initials: D
authors.lastname: Horstkotte
mesh_terms: D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D002908:Chronic Disease; D005246:Feedback; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D016896:Treatment Outcome