SESSION TYPE: Heart Failure Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: The purpose of this study is to evaluate three years effects of adaptive servo-ventilation (ASV) on sleep apnea (SA), quality of life (QOL) and cardiac function in patients with stable congestive heart failure (CHF) and SA treated with bi-level positive airway pressure (PAP).
METHODS: Subjects were 8 patients with CHF and SA who were treated with bi-level PAP and converted to ASV. We performed pulse oxymetory, nasal airflow, chest and abdominal wall motion and electrocardiographic monitoring system (TEIJIN, Morpheus C) before bi-level PAP (B), on room air (Control;C), and after 1 year (1Y) and 3 years (3Y) of domiciliary ASV. New York Heart Association (NYHA) functional class and minimum symptom appearing activity (METs) by specific activity scale, chest rentogenogrm, Doppler echocardiography, respiratory function and urinary noradrenaline (NAd) were compared before and after 1 year and 3 years of domiciliary ASV.
RESULTS: Apnea hypopnea index (AHI;/h) improved from 32(B) and 23(C) to 6(1Y) and 7(3Y). Central apnea index (CAI;/h) decreased from 10.2(B) and 6.7(C) to 0.5(1Y) and 0.2(3Y). Oxygen desaturation index more than 4% (4%ODI;/h) improved from 27(C) to 4(1Y) and 10(3Y). NYHA and METs had improved tendency in 3Y from 2.6(B) and 2.4(C) to 2.4(1Y) and 2.3(3Y), and from 4.3(C) to 4.4(1Y) and 4.8(3Y), respectively. Cardio-thoracic ratio (CTR;%) reduced from 55(B) and 55(C) to 52(1Y) and 52(3Y). End-systolic left ventricular diameter decreased in 1Y. Percent fractional shortening (%FS;%) and ejection fraction (EF;%) improved from 29(B) and 28(C) to 35(1Y) and 34(3Y), and 53(B) and 53(C) to 62(1Y) and 60(3Y), respectively. Mitral regurgitation and estimated right ventricular systolic pressure (RVsP;mmHg) improved in 3Y. Urinary NAd improved in 3Y from 156(C) to 78(3Y). Percent vital capacity (%) improved from 93(C) to 98(1Y) and 100(3Y).
CONCLUSIONS: These results suggest that 3 years of domiciliary ASV is useful for improving SA, QOL and cardiac function in patients with stable CHF.
CLINICAL IMPLICATIONS: Three years of domiciliary ASV is the useful therapy for treating stable CHF.
DISCLOSURE: The following authors have nothing to disclose: Hitoshi Koito, Munmitsu Ohtagaki, Nobuyuki Hayashi, Miwako Satoh
No Product/Research Disclosure InformationMisugikai Otokoyama Hospital, Yawata, Kyoto, Japan