A Long-Term Prognosis of Adaptive Servo Ventilation Therapy for Patients with Heart Failure -Consideration in Severity of Sleep-Disordered Breathing-

Background: Adaptive servo-ventilation (ASV) is used to treat sleep apnea in heart failure (HF). However, it is unclear whether ASV improves the long-term prognosis for all patients with HF, regardless of the severity of sleep-disordered breathing (SDB). We therefore aimed to estimate the long-term prognosis associated with ASV therapy for patients with HF by the severity of SDB. Methods: Sixty-one consecutive patients with HF (mean age ± standard deviation: 70 ± 10 years) were initiated on ASV therapy for HF treatment after polysomnography. Patients were then classified into the following three groups based on their apnea–hypopnea index (AHI): a severe group with an AHI of ≥40/h (n = 28); a moderate group with an AHI of ≥20/h but <40/h (n = 20); and a mild group with an AHI of <20/h (n = 13). To estimate long-term prognosis, we reviewed the 3-year follow-up data, including that concerning fatal cardiovascular events (death from myocardial infarction, cardioembolic stroke, and fatal cardiac arrhythmias). Results: No significant differences were observed between the three study groups in the risk of fatal cardiovascular events (p = 0.207). Conclusions: Our results suggest that ASV therapy is associated with a good prognosis and that ASV therapy is effective, regardless of the severity of SDB.