Three-month treatment with adaptive servoventilation improves cardiac function and physical activity in patients with chronic heart failure and cheyne-stokes respiration: a prospective randomized controlled trial.
BACKGROUND
Cheyne-Stokes respiration frequently occurs in patients with congestive heart failure (CHF). Adaptive servoventilation (ASV) is a novel therapy with potential benefits. This prospective randomized trial investigated the effects of ASV on myocardial function and physical capacity.


METHODS
Patients with severe CHF, despite optimal cardiac medication and/or left ventricular ejection fraction (LVEF) ≤40% and Cheyne-Stokes breathing for >25% of sleeping time were included. Fifty-one patients, age 57-81 years (4 were women), were randomized to either an ASV or a control group; 30 patients completed the study (15 from each group). The primary end point was any change in LVEF. The secondary end points were alterations in physical capacity according to the 6-min walk test or the New York Heart Association (NYHA) class.


RESULTS
In the ASV-treatment group, LVEF improved from baseline (32 ± 11%) to study end (36 ± 13%), p = 0.013. The 6-min walk test improved from 377 ± 115 to 430 ± 123 m (p = 0.014) and the NYHA class from 3.2 (3.0-3.0) to 2.0 (2.0-3.0) (p < 0.001). No changes occurred in the control group.


CONCLUSIONS
Three months of ASV treatment improved LVEF and physical capacity in CHF patients with Cheyne-Stokes respiration. These results suggest that ASV may be a beneficial supplement to standard medication in these patients.
University of Oslo, Oslo, Norway.
Arild
A
Hetland
Kristina H
KH
Haugaa
Margareth
M
Olseng
Ola
O
Gjesdal
Stian
S
Ross
Jørg
J
Saberniak
Morten B
MB
Jacobsen
Thor
T
Edvardsen
D000368:Aged; D000369:Aged, 80 and over; D002639:Cheyne-Stokes Respiration / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology