Acute Effects of Continuous Positive Airway Pressure and Adaptive Servoventilation on Sympathetic Nerve Activity in Patients with Chronic Heart Failure

Abstract

Purpose: We evaluated the effects of short-term continuous positive airway pressure (CPAP) and adaptive-servo ventilation (ASV) on heart rate valiability in patients with chronic heart failure. Methods: We measured blood pressure, oxygen saturation, heart rate valiability and respiratory rate at basline and after the10minute application of ASV. We measured the same parameters again at baseline and after the 10minute application of CPAP in 14 patients (12men, average EF = 35%, age = 69, BNP = 429) with chronic heart failure. Results: There were no significant difference in baseline parameters between ASV and CPAP. There were no effect of CPAP and ASV on blood pressure (ASV:113.5/67.9 to 116.2/67.5 mmHg, P = .29, CPAP:111.3/65.8 to 115.0/66.5 mmHg, P = .13), oxygen saturation(ASV:96.6 to 97.1%, P = .08, CPAP:96.4 to 96.7%, P = .26) and R-R interval(ASV:886 to 903 msec, P = .09, CPAP:872 to 827 msec, P = .44). ASV significantly reduced the ratio of low frequency to high frequency power(LF/HF) ratio(1.64 to 0.98, P = .04) and decreased resipiratory rate(17.8 to 15.6, P = .03). But there were no signicant effect of CPAP on LF/HF ratio(1.29 to 1.00, P = .28) and resipiratory rate(17.1 to16.7, P = .37). Conclusion: In patients with chronic heart failure, ASV more effectively reduced sympathetic nerve activity than CPAP.