Central apnoeas, sympathetic activation and mortality in heart failure: look before you leap

Extract

In the recently published work by Tamisier et al. [1], the effect of adaptive servo-ventilation (ASV) on muscle sympathetic nerve activity (MSNA) was evaluated in a small subset of patients from the previously published cohort of the SERVE-HF trial [2]. The primary outcome for this analysis (on which power calculation was based) was the change in MSNA at 3 months follow-up in the two study arms (ASV plus guideline-based medical treatment, n=19, versus guideline-based medical treatment only, n=21). An additional explorative analysis about the impact on mortality of MSNA changes in time was also run by the authors. No significant differences from baseline were found at 3 months, either with respect to burst frequency or burst incidence between the two study arms. The authors also reported a negative impact of the decrease in MSNA burst incidence at 3 months in patients treated with ASV, compared to controls in whom this decrease seemed beneficial.