Key result
Adaptive servo-ventilation therapy for heart failure may require optimal patient selection based on pulmonary congestion or right ventricular dysfunction, and appropriate device settings.
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Optimal patient selection based on markers of pulmonary congestion and right ventricular dysfunction, combined with appropriate device settings, may be necessary for successful ASV therapy in heart failure.
Clinical advantages in the adaptive servo-ventilation (ASV) therapy have been reported in selected heart failure patients with/without sleep-disorder breathing, whereas multicenter randomized control trials could not demonstrate such advantages. Considering this discrepancy, optimal patient selection and device setting may be a key for the successful ASV therapy. Hemodynamic and echocardiographic parameters indicating pulmonary congestion such as elevated pulmonary capillary wedge pressure were reported as predictors of good response to ASV therapy. Recently, parameters indicating right ventricular dysfunction also have been reported as good predictors. Optimal device setting with appropriate pressure setting during appropriate time may also be a key. Large-scale prospective trial with optimal patient selection and optimal device setting is warranted.
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Imamura et al. (2018) conducted a review in Heart failure with/without sleep-disorder breathing. Adaptive servo-ventilation (ASV) therapy was evaluated. Adaptive servo-ventilation therapy for heart failure may require optimal patient selection based on pulmonary congestion or right ventricular dysfunction, and appropriate device settings.
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