Adaptive servo ventilation improves Cheyne-Stokes respiration, cardiac function, and prognosis in chronic heart failure patients with cardiac resynchronization therapy.
BACKGROUND
Cheyne-Stokes respiration (CSR-CSA) is often observed in patients with chronic heart failure (CHF). Although cardiac resynchronization therapy (CRT) is effective for CHF patients with left ventricular dyssynchrony, it is still unclear whether adaptive servo ventilation (ASV) improves cardiac function and prognosis of CHF patients with CSR-CSA after CRT.


RESULTS
Twenty two patients with CHF and CSR-CSA after CRT defibrillator (CRTD) implantation were enrolled in the present study and randomly assigned into two groups: 11 patients treated with ASV (ASV group) and 11 patients treated without ASV (non-ASV group). Measurement of plasma B-type natriuretic peptide (BNP) levels (before 3, and 6 months later) and echocardiography (before and 6 months) were performed in each group. Patients were followed up to register cardiac events (cardiac death and re-hospitalization) after discharge. In the ASV group, indices for apnea-hypopnea, central apnea, and oxyhemoglobin saturation were improved on ASV. BNP levels, cardiac systolic and diastolic function were improved with ASV treatment for 6 months. Importantly, the event-free rate was significantly higher in the ASV group than in the non-ASV group.


CONCLUSIONS
ASV improves CSR-CSA, cardiac function, and prognosis in CHF patients with CRTD. Patients with CSR-CSA and post CRTD implantation would get benefits by treatment with ASV.
Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.
Makiko
M
Miyata
Akiomi
A
Yoshihisa
Satoshi
S
Suzuki
Shinya
S
Yamada
Masashi
M
Kamioka
Yoshiyuki
Y
Kamiyama
Takayoshi
T
Yamaki
Koichi
K
Sugimoto
Hiroyuki
H
Kunii
Kazuhiko
K
Nakazato
Hitoshi
H
Suzuki
Shu-ichi
S
Saitoh
Yasuchika
Y
Takeishi
D058406:Cardiac Resynchronization Therapy; D002639:Cheyne-Stokes Respiration / Q000628:therapy*; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D017286:Polysomnography; D012121:Respiration, Artificial / Q000379:methods; D016896:Treatment Outcome
D020097:Natriuretic Peptide, Brain