Adaptive servoventilation significantly improved left ventricular ejection fraction by an absolute 4.04%, along with exercise capacity and respiratory stability, in patients with chronic heart failure and Cheyne-Stokes respiration.
Cohort (n=115)
Single-blind
No
Does adaptive servoventilation improve cardiac function and respiratory stability in patients with chronic heart failure and Cheyne-Stokes respiration?
In patients with HFrEF and Cheyne-Stokes respiration, adherence to adaptive servoventilation is associated with improvements in surrogate markers of cardiac function, exercise capacity, and respiratory stability.
Effect estimate: absolute increase of 4.04%
Absolute Event Rate: 34% vs 28.1%
p-value: p=0.003
Cheyne-Stokes respiration (CSR) in patients with chronic heart failure (CHF) is of major prognostic impact and expresses respiratory instability. Other parameters are daytime pCO₂, VE/VCO₂-slope during exercise, exertional oscillatory ventilation (EOV), and increased sensitivity of central CO₂ receptors. Adaptive servoventilation (ASV) was introduced to specifically treat CSR in CHF. Aim of this study was to investigate ASV effects on CSR, cardiac function, and respiratory stability. A total of 105 patients with CHF (NYHA ≥ II, left ventricular ejection fraction (EF) ≤ 40%) and CSR (apnoea-hypopnoea index ≥ 15/h) met inclusion criteria. According to adherence to ASV treatment (follow-up of 6.7 ± 3.2 months) this group was divided into controls (rejection of ASV treatment or usage <50% of nights possible and/or <4 h/night; n = 59) and ASV (n = 56) adhered patients. In the ASV group, ventilator therapy was able to effectively treat CSR. In contrast to controls, NYHA class, EF, oxygen uptake, 6-min walking distance, and NT-proBNP improved significantly. Moreover, exclusively in these patients pCO₂, VE/VCO₂-slope during exercise, EOV, and central CO₂ receptor sensitivity improved. In CHF patients with CSR, ASV might be able to improve parameters of SDB, cardiac function, and respiratory stability.
Oldenburg et al. (Sat,) conducted a cohort in Chronic heart failure with Cheyne-Stokes respiration (n=115). Adaptive servoventilation vs. Control group (rejected or non-compliant to ASV) was evaluated on Left ventricular ejection fraction (absolute increase of 4.04%, p=0.003). Adaptive servoventilation significantly improved left ventricular ejection fraction by an absolute 4.04%, along with exercise capacity and respiratory stability, in patients with chronic heart failure and Cheyne-Stokes respiration.