title: Effect of adaptive servoventilation on muscle sympathetic nerve activity in patients with chronic heart failure and central sleep apnea.
abstract: BACKGROUND
  Adaptive servoventilation (ASV) improves cardiac function and sympathetic nerve activity in patients with heart failure (HF). However, the mechanisms underlying these improvements remain obscure.
  
  
  RESULTS
  We compared muscle sympathetic nerve activity (MSNA) and cardiorespiratory polygraphy and echocardiography findings at baseline and at 3.5 ± 0.8 months' follow-up in 32 patients with HF (New York Heart Association functional class II or III; ejection fraction <45%) and central sleep apnea (CSA; apnea-hypopnea index [AHI] ≥15/h) who consented (n = 20; ASV group) or declined (n = 12; non-ASV group) to undergo ASV treatment. Compliance with ASV and changes in AHI were determined from data collected by integral counters in devices and from cardiorespiratory polygraphic findings, respectively. Ejection fraction and MSNA significantly changed in the ASV (both P < .001) but not the non-ASV group. Although changes in AHI and MSNA correlated, the average use of ASV did not. In contrast, changes in AHI and the average use of ASV were independent predictors of changes in ejection fraction (both P < .01).
  
  
  CONCLUSIONS
  ASV decreases MSNA and improves cardiac function in association with suppression of CSA in patients with HF.
authors.affiliation: Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan. sjoho@med.u-toyama.ac.jp
authors.forename: Shuji
authors.initials: S
authors.lastname: Joho
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Oda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Ushijima
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Hirai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology*; D011379:Prognosis; D020182:Sleep Apnea, Central / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D018709:Statistics, Nonparametric; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents