TY - JOUR T1 - Effect of auto servo-ventilation (ASV) and continuous positive airway pressure (CPAP) on B-type natriuretic peptide (NT-proBNP) in patients with co-existing obstructive (OSA) and central sleep apnea (CSA) in heart failure (HF) JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p1744 AU - Winifried Randerath AU - G. Nothofer AU - N. Anduleit AU - M. Treml AU - C. Priegnitz AU - W. Galetke Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p1744.abstract N2 - Introduction: The optimal ventilatory mode for patients with co-existing OSA and CSA in HF is unclear. We investigated the effects of ASV and CPAP therapy on NT-proBNP, a marker of HF severity.Methods: 70 patients (66.3±9.1 y., 31.3±6.0 kg/m2) with <80% Cheyne-Stokes respiration and 20-50% obstructive disturbances were randomly assigned to either ASV or CPAP treatment (BiPAP autoSV, Philips-Respironics). Polysomnographic parameters and NT-proBNP levels were measured at baseline and after 12 months. Data of patients who used their device during the whole period were analyzed (26 ASV, 25 CPAP). For further analysis, patients were divided into responders (AHI<10/h and <50% below baseline AHI) and non-responders.Results: AHI significantly improved in both groups (ASV: 48.0±25.0 vs. 6.9±6.8/h, p<0.001, CPAP: 41.6±15.4 vs. 11.4±9.6/h, p<0.001). ASV was superior in reducing central disturbances (5.0±5.9 vs. 9.1±8.2, p<0.05). NT-proBNP was similar at baseline and improved after 12 months only in the ASV group (ASV: 537±892 vs. 241±315ng/L, CPAP: 687±979 vs. 876±1882 ng/L, p<0.05). There were 32 responders (19 ASV, 13 CPAP) and 19 non-responders (7 ASV, 12 CPAP). NT-proBNP among responders was lower after treatment (214±236 vs. 1016±2121, p=0.07).Conclusions: Effective treatment of co-existing OSA and CSA with ASV improves NT-proBNP levels, suggesting a relief of cardiac load. This may be related to a more efficient reduction of central disturbances in this group of patients compared to CPAP. ER -