[Efficacy of adaptive pressure support servo-ventilation in patients with congestive heart failure and Cheyne-Stokes respiration].

ABSTRACT

OBJECTIVE: To investigate the efficacy of adaptive pressure support servo-ventilation (APSSV) on Cheyne-Stokes respiration (CSR) in congestive heart failure (CHF). METHODS: 14 patients with CHF and CSR were recruited. During sleep, oxygen therapy and APSSV were separately performed. Comparison before and after each treatment was made for the following items a) parameters of sleep respiration, sleep structure and quality; b) cardiac function index such as left ventricle ejection fraction (LVEF) and 6 minutes' walking distance; c) plasma endothelin-1 (ET-1) levels. RESULTS: Compared with the baseline level before treatment, the apnea hypopnea index significantly decreased during oxygen therapy (P < 0.05) and further declined during APSSV (P < 0.01); on the contrary, the lowest pulse oxygen saturation increased during oxygen therapy (P < 0.05) and further elevated during APSSV (P < 0.01). Compared with arousal index before treatment, it was significantly lower during oxygen therapy (P < 0.05) and the lowest during APSSV (P < 0.01). Compared with both during oxygen therapy and before treatment, during APSSV the percentage ofI + II stage sleep time/total sleep time was significantly lower while the percentage of III + IV stage sleep time/total sleep time was significantly higher. The above percentages during oxygen therapy and before treatment showed no significant difference (P < 0.05). LVEF was significantly higher during APSSV than during oxygen therapy and before treatment (P < 0.05). Six minutes' walking distance was the shortest before treatment and the longest during APSSV. There was a significant difference among that before treatment, during oxygen therapy and APSSV (all P < 0.01). The plasma ET-1 level showed significantly lower during APSSV than that before and during oxygen treatment (P < 0.05), but no significant difference between the levels before and during oxygen treatment (P > 0.05). CONCLUSION: APSSV, more effective than oxygen therapy, is of great clinical significance in improvement of CHF and its prognosis by a better sleep and breathing.