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

Arzt, Michael; Schroll, Stephan; Sériès, Frédéric; Lewis, Keir; Benjamin, Amit; Escourrou, P.; Luigart, Ruth; Kehl, Victoria; Pfeifer, Michael

doi:10.1183/09031936.00083312

Cited by 81 publications

(54 citation statements)

References 38 publications

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“…Thus, ASV, particularly ASV with auto-titrating EPAP, may be a therapeutic option for SDB without the need to distinguish between OSA and CSA. Three randomized controlled trials assessed the effects of ASV on cardiac function in chronic HF patients with coexisting OSA and CSA [55,113,114] . These studies reported significant improvements in cardiac functions, especially reductions in neurohumoral factors.…”

Section: Acute Decompensated Hfmentioning

confidence: 99%

Positive airway pressure therapy for heart failure

Kato

Suda

Kasai

2014

WJC

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Section: Acute Decompensated Hfmentioning

confidence: 99%

Positive airway pressure therapy for heart failure

Kato

Suda

Kasai

2014

WJC

View full text Add to dashboard Cite

“…Table 2). 39,[92][93][94][95][96][97][98][99][100][101][102] The majority of studies have been conducted in patients with HF-rEF, but beneficial effects of ASV on respiratory and cardiovascular parameters have also been documented in patients with HF-pEF. 92 Data from a recent meta-analysis showed that ASV significantly improved AHI, left ventricular function and exercise capacity compared with control in patients who had CSA and predominantly HF-rEF.…”

Section: Treatment Of Central Sleep Apnoeamentioning

confidence: 99%

Sleep-disordered Breathing in Heart Failure – Current State of the Art

Cowie

Woehrle

Oldenburg

et al. 2015

Cardiac Failure Review

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In developed countries, approximately 1-2 % of the adult population has heart failure (HF), and the prevalence of this cardiovascular disease increases with age.1,2 HF can occur in the presence or absence of reduced left ventricular ejection fraction (LVEF), known as HF with reduced ejection fraction (HF-rEF) and HF with preserved ejection fraction (HF-pEF), respectively. The most widely studied of these is HF-rEF, which is particularly prevalent in men with ischaemic heart disease.3 HF-pEF is present in 40-50 % of HF patients. 4,5 It is more prevalent in women and the underlying aetiology is more often non-ischaemic. 3,6 Despite these differences, the negative prognostic impact of both HF-rEF and HF-pEF appears to be similar. 6 The prevalence of renal disease and sleep-disordered breathing (SDB) is similar in patients with HF-rEF or HF-pEF, but the profile of other co-morbidities differs, with pulmonary disease, anaemia and obesity tending to be more prevalent in HF-pEF patients. 7 Even with the wide range of therapeutic options available for patients with HF-rEF and treatment being optimised according to current guideline recommendations, most HF-rEF patients will eventually die from progressive disease; for HF-pEF there are still no evidence-based treatments available, so the focus is mainly on treatment of co-morbidities and optimising risk factors. and often a combination of the two, is highly prevalent in patients with heart failure (HF), is associated with reduced functional capacity and quality of life, and has a negative prognostic impact. European HF guidelines identify that sleep apnoea is of concern in patients with HF. Continuous positive airway pressure is the treatment of choice for OSA, and adaptive servoventilation (ASV) appears to be the most consistently effective therapy for CSA/CSR while also being able to treat concomitant obstructive events. There is a growing body of evidence that treating SDB in patients with HF, particularly using ASV for CSA/CSR, improves functional outcomes such as HF symptoms, cardiac function, cardiac disease markers, exercise tolerance and quality of life. However, conflicting results have been reported on 'hard' outcomes such as mortality and healthcare utilisation, and the influence of effectively treating SDB, including CSA/CSR, remains to be determined in randomised clinical trials. Two such trials (SERVE-HF and ADVENT-HF) in chronic stable HF and another in post-acute decompensated HF (CAT-HF) are currently underway. KeywordsObstructive sleep apnoea, central sleep apnoea, heart failure, adaptive servoventilation, continuous positive airway pressure Disclosure: Professor Cowie is co-principal investigator of the SERVE-HF study, and receives research and consultancy fees from ResMed. Acknowledgement: Medical writing support was provided by Nicola Ryan, independent medical writer, funded by ResMed. Sleep-disordered Breathing in Heart Failure -Current State of the Art Received 17SDB is characterised by intermittent hypoxia, reoxygenation, hypercapnia, arousals a...

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“…As the interest of ASV remains debated in patients with CHF and ''pure'' central sleep apnoea [2], there is no clear evidence of the superiority of ASV over constant positive airway pressure (CPAP) in patients with CHF and COSA [3][4][5]. In our opinion, some aspects of the report by ARZT et al [1] need to be underlined and discussed because of their potential daily clinical implications as well as the design of future studies.…”

mentioning

confidence: 94%

“…We read with great interest the recent report by ARZT et al [1]. They investigated the potential benefit of auto-servoventilation (ASV) in addition to an optimal medical management (OMM) on cardiac function and quality of life in patients with congestive heart failure (CHF) coexisting with central and obstructive sleep apnoea (COSA).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Is auto-servoventilation unnecessary in patients with heart failure and apnoea?

Jaffuel¹,

Combes²,

Molinari

et al. 2014

Eur Respir J

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Recently, using the expensive and time-consuming ELISA method, HERESI et al. [10] have shown that plasma IL-6 concentrations .4.7 pg?mL -1 provide incremental prognostic information in PAH, with valid concentrations above the theoretical sensitivity (LLOD 0.7 pg?mL -1 ). Similarly, using MSD multiplex technology, SOON et al. [2] showed that serum IL-6 was also associated with survival in PAH patients, with concentrations (19.87¡7.45 pg?mL -1 ) above the sensitivity (LLOQ 1.58 pg?mL -1), making such a cytokine very promising for the prognosis of PAH.In conclusion, multiplex analysis provides much information from a single biological sample, and is therefore popular and more frequently used in PAH studies. However, cytokine concentrations are low and often close to the sensitivity of the assay, depending on the multiplex assays. This currently prevents the routine clinical use of such biomarkers, and should encourage clinicians to take advantage of the biochemists' analytic experience. @ERSpublications Sensitivity must be considered for cytokines when using multiplex technology in PAH-related clinical studies http://ow.ly/tAT9l

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

Cited by 81 publications

References 38 publications

Positive airway pressure therapy for heart failure

Positive airway pressure therapy for heart failure

Sleep-disordered Breathing in Heart Failure – Current State of the Art

Is auto-servoventilation unnecessary in patients with heart failure and apnoea?

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