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- Titel:
Long-term auto-servoventilation or constant positive pressure in heart failure and coexisting central with obstructive sleep apnea.
- Dokumenttyp:
- Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
- Autor(en):
- Randerath, WJ; Nothofer, G; Priegnitz, C; Anduleit, N; Treml, M; Kehl, V; Galetke, W
- Abstract:
- The coexistence of obstructive sleep apnea (OSA) and central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) is common in patients with heart failure (HF). While CPAP improves CSA/CSR by about 50%, maximal suppression is crucial in improving clinical outcomes. Auto-servoventilation (ASV) effectively suppresses CSA/CSR in HF, but few trials have been performed in patients with coexisting OSA and CSA/CSR. Our objective was to evaluate a randomized, controlled trial to compare the efficacy of ASV and CPAP in reducing breathing disturbances and improving cardiac parameters in patients with HF and coexisting sleep-disordered breathing.Both modes were delivered using the BiPAP autoSV (Philips Respironics) over a 12-month period. Seventy patients (63 men, 66.3 ± 9.1 y, BMI 31.3 ± 6.0 kg/m(2)) had coexisting OSA and CSA/CSR, arterial hypertension, coronary heart disease, or cardiomyopathy and clinical signs of heart failure New York Heart Association classes II-III. Polysomnography, brain natriuretic peptide (BNP), spiroergometry, and echocardiography were performed at baseline and after 3 and 12 months of treatment.Both modes of therapy significantly improved respiratory disturbances, oxygen desaturations, and arousals over the study period. ASV reduced the central apnea hypopnea index (baseline CPAP, 21.8 ± 11.7; ASV, 23.1 ± 13.2; 12 months CPAP, 10.7 ± 8.7; ASV, 6.1 ± 7.8, P < .05) and BNP levels (baseline CPAP, 686.7 ± 978.7 ng/mL; ASV, 537.3 ± 891.8; 12 months CPAP, 847.3 ± 1848.1; ASV, 230.4 ± 297.4; P < .05) significantly more effectively as compared with CPAP. There were no relevant differences in exercise performance and echocardiographic parameters between the groups.ASV improved CSA/CSR and BNP over a 12-month period more effectively than CPAP.
- Zeitschriftentitel:
- Chest
- Jahr:
- 2012
- Band / Volume:
- 142
- Heft / Issue:
- 2
- Seitenangaben Beitrag:
- 440-7
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1378/chest.11-2089
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/22281801
- Print-ISSN:
- 0012-3692
- TUM Einrichtung:
- Institut für Medizinische Statistik und Epidemiologie
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