Potential for Use of Non Invasive Lung Ventilation in Patients With Decompensated Chronic Heart Failure

Summary. This open controlled singlecentre study was designed to evaluate efficacy of non-invasive lung ventilation (NIV) in patients with decompensated chronic heart failure (DCHF). Inclusion criteria were inpatient DCHF complicating ischaemic heart disease (IHD) or dilated cardiomyopathy (DCM); the ejection fraction of the left ventricle (EFLV) < 35 %, NYHA functional classes III–IV, age > 40 years, increase in dyspnea during previous 7 days. The study involved 33 patients (22 males and 11 females, mean age, 58.94 ± 9.76 years; EFLV, 28.84 ± 5.47 %). The patients were randomized into 2 groups: the 1 st group (n = 22) was treated with the conventional therapy (inhibitors of angiotensinconverting enzyme, nitrates, digoxin, diuretics, statins) and NIV (BiPAP or CPAP, 6–8 h / day). The 2nd group (n = 11) received medications only. The 1 st group patients demonstrated more remarkable improvements in dyspnea, heart beat rate, breathing rate and lung function compared to the 2 nd group patients (p < 0.01). Treatment with HIV increased EFLV, reduced the LV size, decreased blood levels of BNP (p = 0.015), IL6 (p = 0.015) and CRP (p = 0.006). In the control group, there were no significant changes in central haemodynamics, lung function, BNP concentration or systemic inflammation markers to the 10–14 th days of therapy. NIV was well tolerated; no serious adverse event was recorded during the study. Therefore, NIV could greatly improve dyspnea, central haemodynamics, lung function, and LV dysfunction and reduce systemic inflammation in patients with DCHF.