Effectiveness of adaptive servo-ventilation for treating heart failure regardless of the severity of sleep-disordered breathing.

摘要

BACKGROUND: It is unclear whether adaptive servo-ventilation (ASV) is effective for all patients with heart failure (HF). The aim of the present study was therefore to investigate the effectiveness of ASV for all patients with HF. METHODS AND RESULTS: Sixty-one patients with HF were recommended for ASV treatment, regardless of sleep-disordered breathing (SDB) severity and type. On the basis of the apnea-hypopnea index (AHI) results, patients were classified into 3 groups: 28 patients with AHI >/= 40/h were designated as group A; 20 patients with AHI >/= 20/h and <40/h were designated as group B; and 13 patients with AHI < 20/h were designated as group C. After ASV treatment, brain natriuretic peptide (BNP) levels and left ventricular ejection fraction (LVEF) were improved almost equally in the 3 groups (changes in BNP level: group A, -313 +/- 480 pg/ml; group B, -401 +/- 801 pg/ml; group C, -225 +/- 240 pg/ml; P = 0.69; changes in LVEF: group A, 8.5 +/- 11.3%; group B, 10.5 +/- 9.6%; group C, 2.4 +/- 12.4%; P = 0.17). CONCLUSIONS: ASV treatment for patients with mild SDB resulted in almost equal improvements in BNP levels and LVEF compared to that in patients with moderate and severe SDB, demonstrating that ASV is effective for all patients with HF.