Safety and efficacy of adaptive servo-ventilation in patients with severe systolic heart failure

Takama, Noriaki; Kurabayashi, Masahiko

doi:10.1016/j.jjcc.2013.09.008

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…11- 17 Patients with LV reverse remodeling have a very favorable prognosis as compared with patients who do not. 18 The present study was conducted as a multicenter, randomized, controlled study in order to examine the superiority of the ASV group to the control group regarding the cardiac function-improving and LV remodeling-inducing effects of ASV therapy that SAVIOR-R 14 had suggested.…”

mentioning

confidence: 99%

Adaptive Servo-Ventilation Therapy for Patients With Chronic Heart Failure in a Confirmatory, Multicenter, Randomized, Controlled Study

Momomura

Seino

Kihara

et al. 2015

Circ J

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mentioning

confidence: 99%

Adaptive Servo-Ventilation Therapy for Patients With Chronic Heart Failure in a Confirmatory, Multicenter, Randomized, Controlled Study

Momomura

Seino

Kihara

et al. 2015

Circ J

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“…Furthermore, many reports showed that the ASV therapy for the patients with HF was effective. 5,7,9,10,11,[18][19][20][21][22] Although it is well known that the prognosis of patients is negatively correlated with the severity of SDB, 12 little has been reported on the long-term prognosis in patients with HF after initiating ASV therapy. Earlier, we showed that ASV therapy was effective for patients with HF and that it improved their prognosis after one year.…”

Section: Findings and Data Interpretationmentioning

confidence: 99%

“…9 Similarly, other reports suggested that the ASV therapy improved the LVEF, BNP, and the prognosis of patients with HF. 6,10,11 However, previous reports have suggested that there is a negative relationship between the severity of SDB and prognosis. 1,12 It remained unclear as to whether ASV could improve the long-term prognosis of patients with HF, regardless of the severity of SDB.…”

Section: Introductionmentioning

confidence: 99%

A Long-Term Prognosis of Adaptive Servo Ventilation Therapy for Patients with Heart Failure -Consideration in Severity of Sleep-Disordered Breathing-

Goto¹,

Takama²,

Kurabayashi³

2016

J.ATAMIS

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Background: Adaptive servo-ventilation (ASV) is used to treat sleep apnea in heart failure (HF). However, it is unclear whether ASV improves the long-term prognosis for all patients with HF, regardless of the severity of sleep-disordered breathing (SDB). We therefore aimed to estimate the long-term prognosis associated with ASV therapy for patients with HF by the severity of SDB.Methods: Sixty-one consecutive patients with HF (mean age ± standard deviation: 70 ± 10 years) were initiated on ASV therapy for HF treatment after polysomnography. Patients were then classified into the following three groups based on their apnea–hypopnea index (AHI): a severe group with an AHI of ≥40/h (n = 28); a moderate group with an AHI of ≥20/h but <40/h (n = 20); and a mild group with an AHI of <20/h (n = 13). To estimate long-term prognosis, we reviewed the 3-year follow-up data, including that concerning fatal cardiovascular events (death from myocardial infarction, cardioembolic stroke, and fatal cardiac arrhythmias).Results: No significant differences were observed between the three study groups in the risk of fatal cardiovascular events (p = 0.207).Conclusions: Our results suggest that ASV therapy is associated with a good prognosis and that ASV therapy is effective, regardless of the severity of SDB.

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“…This treatment was originally developed to treat sleep-disordered breathing (SDB), but has been widely indicated for the treatment of moderate to advanced heart failure (HF) even in the absence of SDB. [2][3][4][5][6][7][8][9][10][11][12][13][14] Cowie, et al recently demonstrated an increased mortality in patients receiving aggressive ASV therapy for HF and central sleep apnea compared with the control group. 15) Another Japanese prospective randomized controlled study did not show an obvious advantage of ASV therapy over optimal medical therapy.…”

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confidence: 99%

Right Ventricular End-Diastolic Pressure Is a Key to the Changes in Cardiac Output During Adaptive Servo-Ventilation Support in Patients With Heart Failure

Imamura

Kinugawa

2017

Int. Heart J.

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SummaryAdaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. ΔLeft ventricular end-diastolic pressure (LVEDP) did not correlate with ΔCI, whereas Δtransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and ΔCI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0.009, r = 0.311). Among baseline data, higher RVEDP and higher LVEDP were significant predictors of an acute response by logistic regression analyses (P < 0.05 for both). RVEDP had a significantly higher area under the curve than LVEDP in the receiver operating characteristic analyses (0.846 versus 0.673, P = 0.028). Higher baseline RVEDP was significantly associated with a greater decrease in RVEDP during ASV (P < 0.001, r = -0.604). In conclusion, in HF patients with elevated RVEDP, ASV increased cardiac output through a decrease in RVEDP and an increase in transmural LVEDP, according to the ascending limb of Frank-Starling's law. (Int Heart J 2017; 58: 536-543)

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Safety and efficacy of adaptive servo-ventilation in patients with severe systolic heart failure

Abstract: Our study demonstrated that ASV therapy is safe and effective for use in very severe systolic HF patients as well as in relatively mild systolic HF patients.

Cited by 20 publications

References 31 publications

Adaptive Servo-Ventilation Therapy for Patients With Chronic Heart Failure in a Confirmatory, Multicenter, Randomized, Controlled Study

Adaptive Servo-Ventilation Therapy for Patients With Chronic Heart Failure in a Confirmatory, Multicenter, Randomized, Controlled Study

A Long-Term Prognosis of Adaptive Servo Ventilation Therapy for Patients with Heart Failure -Consideration in Severity of Sleep-Disordered Breathing-

Right Ventricular End-Diastolic Pressure Is a Key to the Changes in Cardiac Output During Adaptive Servo-Ventilation Support in Patients With Heart Failure

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