title: Adaptive servoventilation improves cardiac dysfunction and prognosis in heart failure patients with sleep-disordered breathing: a meta-analysis.
abstract: BACKGROUND
  Adaptive servoventilation (ASV) is a new therapeutic modality to treat sleep-disordered breathing (SDB) especially for central sleep apnoea associated with Cheyne-Stokes respiration, whereas the role of ASV in SDB patients with heart failure (HF) is controversial. The purpose of this study was to evaluate the effects of ASV on these patients through a meta-analysis of published data.
  
  
  METHODS
  A comprehensive literature search was performed to identify studies focused on ASV through databases, including PubMed, Medline, Embase, Cochrane Library and Web of science from 1950 to 2014. Parallel randomised controlled trials which compared ASV to other controls in HF and SDB patients with extractable data were meet our inclusion criteria. Random effects meta-analysis models were applied using RevMan 5.2.
  
  
  RESULTS
  Seven studies involving 301 patients were recruited in the meta-analysis. The weighted mean difference in apnoea hyponea index (-17.73 events/h, 95% CI, -21.85 to -2.94) and left ventricular ejection fraction (MD: 4.68, 95% CI, 2.74-6.63) both favored ASV compared to control conditions. The urinary noradrenaline level (MD: -32.18, 95%CI: -44.07 to -20.09) was decreased, while the exercise capacity measured by 6-min walk distance (MD: 41.26, 95% CI, 17.06-65.45) was improved after ASV treatment. Whereas neither left ventricular end-diastolic diameter (LVEDD) nor Epworth sleepiness-scale score (ESS) significantly changed after ASV therapy.
  
  
  CONCLUSIONS
  ASV is superior to other therapy, as it can result in good consequences for patients with SDB and improve their prognosis in cardiac function. Further studies will still be needed to assess the benefit of it.
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Clinical Center for Breathing Disorder and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Clinical Center for Breathing Disorder and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Cuiping
authors.initials: C
authors.lastname: Fu
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Clinical Center for Breathing Disorder and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Shuqi
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Clinical Center for Breathing Disorder and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Zilong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Clinical Center for Breathing Disorder and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Shanqun
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002639:Cheyne-Stokes Respiration / Q000150:complications; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000628:therapy; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000652:urine; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000628:therapy; D020182:Sleep Apnea, Central / Q000628:therapy; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D009638:Norepinephrine
keywords: adaptive servoventilation; central sleep apnoea; heart failure; meta-analysis; sleep-disordered breathing