Adaptive Servo Ventilation Prevents Rehospitalization in Chronic Heart Failure Patients with Cheyne-Stokes Respiration

Abstract

Chronic heart failure (CHF) is a prevalent syndrome with adverse prognosis, especially the major cause of death and re-hospitalization in the elderly, and secondary prevention is important. Identification of factors that contribute to increased mortality might lead to the development of a new strategy to improve survival of CHF. It has been reported that about 50% of CHF patients have sleep apnea syndrome (SAS), which consists of obstructive sleep apnea (OSA) and Cheyne-Stokes respiration with central sleep apnea (CSR-CSA). Adaptive servo ventilation (ASV) is a ventilator support system specifically designed to normalize ventilation in patients with CSR-CSA and OSA. ASV can regulate the airway ventilation volume according to the demand based on the variable tidal volume throughout the period of CSR-CSA. It has been reported that ASV improves not only SAS, but also cardiac function (eg. LVEF, BNP, exercise capacity etc). We demonstrate short and long term effects of ASV on cardiac function and cardiovascular events in CHF with CSR-CSA. Adaptive servo ventilation might be a promising useful tool for chronic heart failure as an important non-pharmacotherapy.