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Acute Hemodynamic Effects of Adaptive Servo-Ventilation in Patients With Heart Failure.
MedLine Citation:
PMID:  23363644     Owner:  NLM     Status:  Publisher    
Background: Adaptive servo-ventilation (ASV) improves cardiac function in patients with heart failure (HF). We compared the hemodynamics of control and HF patients, and identified the predictors for acute effects of ASV in HF. Methods and Results: We performed baseline echocardiographic measurements and hemodynamic measurements at baseline and after 15min of ASV during cardiac catheterization in 11 control and 34 HF patients. Heart rate and blood pressure did not change after ASV in either the control or HF group. Stroke volume index (SVI) decreased from 49.3±7.6 to 41.3±7.6ml/m(2) in controls (P<0.0001) but did not change in the HF patients (from 34.8±11.5 to 32.8±8.9ml/m(2), P=0.148). In the univariate analysis, pulmonary capillary wedge pressure (PCWP), mitral regurgitation (MR)/left atrial (LA) area, E/A, E/e', and the sphericity index defined by the ratio between the short-axis and long-axis dimensions of the left ventricle significantly correlated with % change of SVI from baseline during ASV. PCWP and MR/LA area were independent predictors by multivariate analysis. Moreover, responders (15 of 34 HF patients; 44%) categorized by an increase in SVI showed significantly higher PCWP, MR, and sphericity index. Conclusions: Left ventricular structure and MR, as well as PCWP, could predict acute favorable effects on hemodynamics by ASV therapy in HF patients.
Shiro Yamada; Mamoru Sakakibara; Takashi Yokota; Kiwamu Kamiya; Naoya Asakawa; Hiroyuki Iwano; Satoshi Yamada; Koji Oba; Hiroyuki Tsutsui
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-30
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.
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