Abstract
Introduction: Adaptive-servo ventilation (ASV) is helpful in treating for sleep disordered breathing (SDB) in patients with heart failure (HF). ASV devices provide information on residual respiratory events while patients using them. However, it has not been fully evaluated whether the apnea-hypopnea index (AHI) determined by the AutoSet CS (ACS), an ASV device is in good accordance with the AHI detected by polysomnography in HF patients with SDB.
Methods: Consecutive patients with SDB who were titrated on ASC were included. We assessed the correlation between the AHI determined by manual scoring on polysomnography (AHI-P) and by ASC (AHI-ASC) during an overnight polysomnography on ASV.
Results: Thirty HF patients with SDB (age, 68.8±2.8 years; 2 women; LVEF, 53.8±3.4%) were enrolled. The mean AHI on the diagnostic study was 34.2±3.6 events/hour including both obstructive and central respiratory events. During the titration, ASV devices markedly suppressed the respiratory events (AHI-P, 4.1±0.8 events/hour), while the mean AHI-ASC was 11.6±1.3 events/hour. We found a modest correlation between the AHI-P and the AHI-ASC (r=0.36, p=0.04). Brand-Altman plot indicated that ASC generally overestimated AHI but agreement was not too poor.
Discussion: We found only a modest correlation between the AHI-P and the AHI-ASC. Such discrepancy may be explained by the central respiratory events during wakefulness or sleep-awake transition. Clinicians should take such discrepancy into account when they interpret residual respiratory events determined by ASV devices.
- © 2014 ERS