Document Detail


Adaptive servoventilation in diastolic heart failure and Cheyne-Stokes respiration.
MedLine Citation:
PMID:  20032021     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A high prevalence of nocturnal Cheyne-Stokes respiration (CSR) has been documented in patients with heart failure with normal left ventricular ejection fraction (HFNEF). The aim of the present study was to investigate the effects of adaptive servoventilation (ASV) for treatment of CSR in these patients. In 60 patients with HFNEF, defined according to current European Society of Cardiology guidelines, CSR was documented by polysomnography (apnoea/hypopnoea index (AHI) of >15 events x h(-1)). ASV treatment was offered to all patients; 21 initially rejected treatment, withdrew from treatment or presented noncompliant during follow-up (controls), whereas ongoing ASV therapy was initiated in 39 patients (ASV group). Echocardiography, cardiopulmonary exercise testing and measurement of N-terminal-pro-brain natriuretic peptide were performed at baseline and follow-up (11.6+/-3 months). ASV therapy led to a significant reduction in AHI, longest apnoea and hypopnoea length, maximum and mean oxygen desaturation by pulse oximetry, percentage of study time with an oxygen saturation of <90% and arousal index. In addition, significant positive effects could be confirmed on absolute and predicted peak oxygen consumption, oxygen consumption at the individual aerobic-anaerobic threshold, oxygen pulse, as well as left atrial size, and transmitral flow patterns (mean early diastolic lengthening velocity and the ratio of peak early Doppler mitral inflow velocity to this lengthening velocity). ASV effectively attenuates CSR in patients with HFNEF and improves heart failure symptoms and cardiac function. Whether or not this is accompanied by an improved prognosis remains to be determined.
Authors:
T Bitter; N Westerheide; L Faber; D Hering; C Prinz; C Langer; D Horstkotte; O Oldenburg
Publication Detail:
Type:  Journal Article     Date:  2009-12-23
Journal Detail:
Title:  The European respiratory journal     Volume:  36     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-11-26     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  385-92     Citation Subset:  IM    
Affiliation:
Dept of Cardiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstasse 11, D-32545 Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Catheterization
Cheyne-Stokes Respiration / epidemiology,  physiopathology*
Echocardiography / methods
Exercise
Female
Heart Failure / epidemiology,  physiopathology*
Heart Ventricles / pathology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Polysomnography / methods
Prospective Studies
Sleep Apnea Syndromes / diagnosis,  pathology
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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