title: Beneficial effects of adaptive servo-ventilation therapy on albuminuria in patients with heart failure.
abstract: BACKGROUND
  Short-duration adaptive servo-ventilation (ASV) therapy can be effective for heart failure (HF) patients. Albuminuria is recognized as a prognostic marker for HF. We investigated whether short-duration and short-term ASV therapy reduced albuminuria in HF patients.
  
  
  RESULTS
  Twenty-one consecutive HF patients were divided into two groups: those who tolerated ASV therapy (ASV group, n=14) and those who did not (non-ASV group, n=7). ASV therapy was administered to enrolled patients for 1 week for 2h per day (1h in the morning and 1h in the afternoon). The urinary albumin to creatinine ratio (UACR), urinary 24h norepinephrine (NE) excretion, high-sensitivity C-reactive protein (hs-CRP), and plasma brain natriuretic peptide (BNP) levels were measured before and 1 week after ASV therapy. In the ASV group, but not the non-ASV group, the UACR significantly decreased, together with a decrease in urinary NE and hs-CRP levels. There were significant correlations between the changes in UACR and hs-CRP and between the changes in urinary NE and hs-CRP. Multiple linear regression analyses indicated that ASV use was the strongest predictor of decreased UACR.
  
  
  CONCLUSIONS
  Albuminuria, urinary NE, and hs-CRP levels reduced in HF patients who could receive short-duration and short-term ASV therapy. Anti-inflammatory effects of ASV therapy may partly mediate the reduction of albuminuria.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tamura
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.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan. Electronic address: hirow@doc.med.akita-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Hosoya
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000628:therapy* / Q000652:urine*; D002097:C-Reactive Protein / Q000652:urine; D003404:Creatinine / Q000652:urine; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000652:urine; D011175:Positive-Pressure Respiration / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein; D003404:Creatinine; D009638:Norepinephrine
keywords: Adaptive servo-ventilation; Heart failure; Inflammation; Microalbuminuria; Sympathetic nerve activity