Your browser doesn't support javascript.
loading
Adaptive servo-ventilation and mortality in patients with systolic heart failure and central sleep apnea: a single-center experience.
Sun, Paulina; Porter, Kyle; Randerath, Winfried; Jarjoura, David; Khayat, Rami.
Afiliação
  • Sun P; The UCI Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of California-Irvine, 20350 SW Birch Street, Newport Beach, CA, 92660, USA. sunpt@hs.uci.edu.
  • Porter K; The Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
  • Randerath W; Institute of Pneumology at the University Cologne, Bethanien Hospital, Solingen, Germany.
  • Jarjoura D; The Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
  • Khayat R; The UCI Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of California-Irvine, 20350 SW Birch Street, Newport Beach, CA, 92660, USA.
Sleep Breath ; 27(5): 1909-1915, 2023 10.
Article em En | MEDLINE | ID: mdl-36920657
ABSTRACT

BACKGROUND:

Central sleep apnea (CSA) is associated with increased mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Treatment of CSA with a certain type of adaptive servo-ventilation (ASV) device that targets minute ventilation (ASVmv) was found to be harmful in these patients. A newer generation of ASV devices that target peak flow (ASVpf) is presumed to have different effects on ventilation and airway patency. We analyzed our registry of patients with HFrEF-CSA to examine the effect of exposure to ASV and role of each type of ASV device on mortality.

METHODS:

This is a retrospective cohort study in patients with HFrEF and CSA who were treated with ASV devices between 2008 and 2015 at a single institution. Mortality data were collected through the institutional data honest broker. Usage data were obtained from vendors' and manufacturers' servers. Median follow-up was 64 months.

RESULTS:

The registry included 90 patients with HFrEF-CSA who were prescribed ASV devices. Applying a 3-h-per-night usage cutoff, we found a survival advantage at 64 months for those who used the ASV device above the cutoff (n = 59; survival 76%) compared to those who did not (n = 31; survival 49%; hazard ratio 0.44; CI 95%, 0.20 to 0.97; P = 0.04). The majority (n = 77) of patients received ASVpf devices with automatically adjusting end-expiratory pressure (EPAP) and the remainder (n = 13) received ASVmv devices mostly with fixed EPAP (n = 12). There was a trend towards a negative correlation between ASVmv with fixed EPAP and survival.

CONCLUSION:

In this population of patients with HFrEF and CSA, there was no evidence that usage of ASV devices was associated with increased mortality. However, there was evidence of differential effects of type of ASV technology on mortality.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Disfunção Ventricular Esquerda / Apneia do Sono Tipo Central / Insuficiência Cardíaca Sistólica / Insuficiência Cardíaca Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Disfunção Ventricular Esquerda / Apneia do Sono Tipo Central / Insuficiência Cardíaca Sistólica / Insuficiência Cardíaca Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article