RT Journal Article
SR Electronic
T1 Mortality in heart failure patients with nocturnal Cheyne-Stokes respiration receiving adaptive servoventilation (ASV) therapy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3286
VO 40
IS Suppl 56
A1 Olaf Oldenburg
A1 Thomas Bitter
A1 Birgit Wellmann
A1 Natalie Prib
A1 Britta Körber
A1 Zisis Dimitriadis
A1 Birgit Krause
A1 Thomas Fischbach
A1 Dieter Horstkotte
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3286.abstract
AB Sleep-disordered breathing (SDB) with Cheyne-Stokes respiration (CSR) is of major prognostic impact in heart failure (HF) patients. Adaptive Servoventilation (ASV) therapy was recently introduced to especially treat CSR in these patients. First results on mortality (time of death, left-ventricular assist device (LVAD) device implantation and heart transplantation (HTX)) of a prospective registry are presented.A total of 186 HF patients (NYHA ≥ II, EF ≤ 45%), treated according to present HF guidelines, with nocturnal CSA (apnoea-hypopnoea-Index, AHI ≥ 15/h) received additional ASV treatment (AutoSet CS, ResMed) and were included into a prospective registry. Mean age at inclusion (168 male, 91%) was 67 ± 11 years, BMI 28.8 ± 4.2 kg/qm, NYHA functional class 2.6 ±0.6, NT-proBNP levels 2722 ± 3420 pg/ml, left ventricular ejection fraction 31 ± 8% and peak VO2 during cardiopulmonary exercise testing 14.4 ± 4.7 ml/kg/min. AHI before ASV initiation was 38.8 ± 14.8/h, apnoea-index 22.2 ± 15.2/h. After 20.7 ± 16.1 months a total of 35 patients (18.8%) reached a final endpoint: 28 (15.1%) died, 6 (3.2%) received HTX and one (0.5%) LVAD implantation. Within the follow-up period, ASV therapy was discontinued by 26 patients (14.0%) and 15 patients (8.1%) met indication for cardiac resynchronization therapy (CRT).Mortality in HF patients with nocturnal CSA and ASV treatment remains high. If there is any reduction in mortality and/or hospitalization is currently be investigated by 2 randomized controlled trials, first results are not expected before 2014. With 14% discontinuation, ASV therapy seems to be well tolerated and accepted.