| Long-term auto servo-ventilation or constant positive pressure in heart failure and co-existing central with obstructive sleep apnea. | |
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MedLine Citation:
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PMID: 22281801 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AbstractRationale:The coexistence of Obstructive (OSA) and Central Sleep Apnea (CSA) and Cheyne-Stokes Respiration (CSR) is common in patients with Heart Failure (HF). While Continuous Positive Airway Pressure (CPAP) improves CSA/CSR by about 50%, maximal suppression is crucial in improving clinical outcomes. Auto Servo-Ventilation (ASV) effectively suppresses CSA/CSR in HF, but few trials have been performed in patients with co-existing OSA and CSA/CSR. OBJECTIVES:Randomized, controlled trial to compare the efficacy of ASV and CPAP in reducing breathing disturbances and improving cardiac parameters in patients with HF and co-existing sleep-disordered breathing. METHODS:Both modes were delivered using the BiPAP autoSV®, Respironics, USA over a twelve month period. 70 patients (63 male, 66.3±9.1 y., BMI 31.3±6.0 kg/m(2)) had co-existing OSA and CSA/CSR, arterial hypertension, coronary heart disease or cardiomyopathy and clinical signs of heart failure NYHA II-III. Polysomnography, brain natriuretic peptide, spiroergometry and echocardiography were performed at baseline, after 3 and 12 months of treatment.Measurements and Main RESULTS:Both modes of therapy significantly improved respiratory disturbances, oxygen desaturations and arousals over the study period. ASV reduced the central AHI (Baseline CPAP 21.8±11.7, ASV 23.1±13.2, 12 months CPAP 10.7±8.7, ASV 6.1±7.8, p<0.05) and BNP levels (Baseline CPAP 686.7±978.7ng/ml, ASV 537.3±891.8, 12 months CPAP 847.3±1848.1, ASV 230.4±297.4, p<0.05) significantly more effectively as compared to CPAP. There were no relevant differences in exercise performance and echocardiographic parameters between the groups. CONCLUSIONS:ASV improved CSA/CSR and brain natriuretic peptide over a 12 month period more effectively than CPAP. |
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Authors:
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Winfried J Randerath; Gregor Nothofer; Christina Priegnitz; Norbert Anduleit; Marcel Treml; Victoria Kehl; Wolfgang Galetke |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-26 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Institute of Pneumology at the University Witten/Herdecke, Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, Solingen, Germany (Prof. Randerath, Dres. Priegnitz and Treml and Mr. Nothofer, Mr. Anduleit), Institute of Medical Statistics und Epidemiology, Study Centre Munich, Klinikum r.d. Isar, TUM, Munich, Germany (Dr. Kehl), Krankenhaus der Augustinerinnen, Cologne, Germany (PD Dr. Galetke). |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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