Abstract 10454: Heart Failure With Recovered Ejection Fraction is Good Therapeuticmerkmal for Adaptive-Servo Ventilation Therapy in Patients With Heart Failure

Abstract

Introduction: Heart failure with recovered ejection fraction (HFrecEF) is a complex clinical entity in which biology and clinical management. Previous clinical trial showed adaptive-servo ventilation (ASV) therapy is harmful for patient with heart failure with reduced ejection fraction (HFrEF), whereas we can initiate ASV for patients with HFrEF by adhering rigidly to Japanese statement about the proper use of ASV for HF. Hypothesis: It is still unclear whether ASV therapy is really harmful in patients with HFrecEF. Our aim is to estimate that ASV therapy is really harmful in patients with HFrecEF by estimating biomarkers and fatal cardiovascular events. Methods: The study group consisted of 78 patients with HF (age;70±12 years). Baseline LVEF was 27.8±8.5%. After optimal medical therapy, ASV was initiated as an additional HF treatment. After 6-month follow-up, we classified into 2 groups by result of LVEF after ASV therapy. Group A (n=20) was categorized as HFrecEF {low pre-LVEF (<45%) and improved post-LVEF (≧45%)}, Group B (n=58) was categorized as HFrEF {low pre-LVEF (<45%) and not improved post-LVEF (<45%)}. We estimate the changes of BNP and fatal cardiovascular events after ASV therapy. Results: Before ASV therapy, BNP did not show significant difference in 2 groups {Group A: 439(149-1344) pg/ml vs. Group B: 531(265-892) pg/ml, p=0.73}. After ASV therapy, the changes of BNP showed significant differences (Figure 1A), LVEF also showed significant differences in 2 groups (Group A: 52.3±7.5% vs. Group B: 30.8±3.7%, p=0.039). The fatal cardiovascular events rate after three-year follow-up showed significant good prognosis in Group A (Figure 1B). Conclusions: Our study showed that approximately one in four patients can change from HFrEF to HFrecEF, and ASV is acceptable and effective treatment for patients with HFrecEF by contributing to low fatal cardiovascular events and improvement of BNP level.