Auto-servoventilation in heart failure with sleep apnoea: a randomised controlled trial

Arzt, Michael and Schroll, Stephan and Series, Frederic and Lewis, Keir and Benjamin, Amit and Escourrou, Pierre and Luigart, Ruth and Kehl, Victoria and Pfeifer, Michael (2013) Auto-servoventilation in heart failure with sleep apnoea: a randomised controlled trial. EUROPEAN RESPIRATORY JOURNAL, 42 (5). pp. 1244-1254. ISSN 0903-1936, 1399-3003

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Abstract

We tested the hypotheses that in patients with congestive heart failure (CUP) and sleep disordered breathing (SDB) auto-servoventilation (ASV) improves cardiac function and quality of life. Between March 2007 and September 2009, patients with stable CHF (left ventricular ejection fraction (LVEF) <= 40%) and SDB (apnoea/hypopnoea index >= 20 events.h(-1)) were randomised to receive either ASV (BiPAP ASV (Philips Respironics, Murrysville, PA, USA), n=37) and optimal medical management, or optimal medical management alone (n=35). Outcomes were assessed at baseline and 12 weeks. The apnoea/hypopnoea index assessed with polysomnography scored in one core laboratory was significantly more reduced in the ASV group (-39 +/- 16 versus -1 +/- 13 events.h(-1); p<0.001) with an average use of 4.5 +/- 3.0 h.day(-1). Both groups showed similar improvements of the primary end-point LVEF (+3.4 +/- 5 versus + 3.5 +/- 6%; p=0.915) assessed with echocardiography. In the ASV group, reduction of N-terminal probrain natriuretic peptide (NT-proBNP) was significantly greater (-360 +/- 569 versus +135 +/- 625 ng.mL(-1); p=0.010). No differences were observed between the groups in subjective quality of life. In patients with CHF and SDB, ASV reduced NT-proBNP levels, but improvement of LVEF or quality of life was not greater than in the control group. The data support that such patients can be randomised in large-scale, long-term trials of positive airway pressure therapy versus control to determine effects on cardiovascular outcome.

Item Type: Article
Uncontrolled Keywords: POSITIVE AIRWAY PRESSURE; CHEYNE-STOKES RESPIRATION; NATRIURETIC PEPTIDE; VENTRICULAR DYSFUNCTION; EUROPEAN-SOCIETY; BLOOD-PRESSURE; ASSOCIATION; VENTILATION; PREDICTORS; GUIDELINES;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 25 Mar 2020 10:03
Last Modified: 25 Mar 2020 10:03
URI: https://pred.uni-regensburg.de/id/eprint/15748

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