Three-month treatment with adaptive servoventilation improves cardiac function and physical activity in patients with chronic heart failure and cheyne-stokes respiration: a prospective randomized controlled trial

Cardiology. 2013;126(2):81-90. doi: 10.1159/000350826. Epub 2013 Aug 9.

Abstract

Background: Cheyne-Stokes respiration frequently occurs in patients with congestive heart failure (CHF). Adaptive servoventilation (ASV) is a novel therapy with potential benefits. This prospective randomized trial investigated the effects of ASV on myocardial function and physical capacity.

Methods: Patients with severe CHF, despite optimal cardiac medication and/or left ventricular ejection fraction (LVEF) ≤40% and Cheyne-Stokes breathing for >25% of sleeping time were included. Fifty-one patients, age 57-81 years (4 were women), were randomized to either an ASV or a control group; 30 patients completed the study (15 from each group). The primary end point was any change in LVEF. The secondary end points were alterations in physical capacity according to the 6-min walk test or the New York Heart Association (NYHA) class.

Results: In the ASV-treatment group, LVEF improved from baseline (32 ± 11%) to study end (36 ± 13%), p = 0.013. The 6-min walk test improved from 377 ± 115 to 430 ± 123 m (p = 0.014) and the NYHA class from 3.2 (3.0-3.0) to 2.0 (2.0-3.0) (p < 0.001). No changes occurred in the control group.

Conclusion: Three months of ASV treatment improved LVEF and physical capacity in CHF patients with Cheyne-Stokes respiration. These results suggest that ASV may be a beneficial supplement to standard medication in these patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cheyne-Stokes Respiration / complications
  • Cheyne-Stokes Respiration / physiopathology
  • Cheyne-Stokes Respiration / therapy*
  • Exercise Tolerance / physiology
  • Female
  • Heart Failure / complications
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Positive-Pressure Respiration / methods*
  • Prospective Studies
  • Stroke Volume / physiology
  • Treatment Outcome
  • Walking / physiology