PMID- 18024166
OWN - NLM
STAT- MEDLINE
DCOM- 20081124
LR  - 20080811
IS  - 1389-9457 (Print)
IS  - 1389-9457 (Linking)
VI  - 9
IP  - 6
DP  - 2008 Aug
TI  - Bi-level positive pressure ventilation and adaptive servo ventilation in patients 
      with heart failure and Cheyne-Stokes respiration.
PG  - 652-9
AB  - OBJECTIVES: Nocturnal positive pressure ventilation (PPV) has been shown to be 
      effective in patients with impaired left ventricular ejection fraction (LVEF) and 
      Cheyne-Stokes respiration (CSR). We investigated the effect of a bi-level PPV and 
      adaptive servo ventilation on LVEF, CSR, and quantitative sleep quality. METHODS: 
      Thirty-seven patients (New York heart association [NYHA] II-III) with LVEF<45% 
      and CSR were investigated by electrocardiography (ECG), echocardiography and 
      polysomnography. The CSR index (CSRI) was 32.3+/-16.2/h. Patients were randomly 
      treated with bi-level PPV using the standard spontaneous/timed (S/T) mode or with 
      adaptive servo ventilation mode (AutoSetCS). After 6 weeks, 30 patients underwent 
      control investigations with ECG, echocardiography, and polysomnography. RESULTS: 
      The CSRI decreased significantly to 13.6+/-13.4/h. LVEF increased significantly 
      after 6 weeks of ventilation (from 25.1+/-8.5 to 28.8+/-9.8%, p<0.01). The number 
      of respiratory-related arousals decreased significantly. Other quantitative sleep 
      parameters did not change. The Epworth sleepiness score improved slightly. 
      Daytime blood pressure and heart rate did not change. There were some differences 
      between bi-level PPV and adaptive servo ventilation: the CSRI decreased more in 
      the AutoSetCS group while the LVEF increased more in the bi-level PPV group. 
      CONCLUSIONS: Administration of PPV can successfully attenuate CSA. Reduced CSA 
      may be associated with improved LVEF; however, this may depend on the mode of 
      PPV. Changed LVEF is evident even in the absence of significant changes in blood 
      pressure.
FAU - Fietze, Ingo
AU  - Fietze I
AD  - Charite-Universitatsmedizin Berlin, CCM, Department of Internal Medicine, Center 
      for Sleep Medicine, Luisenstr. 13, D-10117 Berlin, Germany. 
      ingo.fietze@charite.de
FAU - Blau, Alexander
AU  - Blau A
FAU - Glos, Martin
AU  - Glos M
FAU - Theres, Heinz
AU  - Theres H
FAU - Baumann, Gert
AU  - Baumann G
FAU - Penzel, Thomas
AU  - Penzel T
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20071119
PL  - Netherlands
TA  - Sleep Med
JT  - Sleep medicine
JID - 100898759
SB  - IM
MH  - Aged
MH  - Cheyne-Stokes Respiration/complications/physiopathology/*therapy
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure/complications/*physiopathology/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polysomnography
MH  - Positive-Pressure Respiration/*methods
MH  - Sleep Apnea Syndromes/complications/physiopathology/*therapy
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2007/11/21 09:00
MHDA- 2008/12/17 09:00
CRDT- 2007/11/21 09:00
PHST- 2007/03/23 00:00 [received]
PHST- 2007/09/14 00:00 [revised]
PHST- 2007/09/18 00:00 [accepted]
PHST- 2007/11/21 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2007/11/21 09:00 [entrez]
AID - S1389-9457(07)00350-4 [pii]
AID - 10.1016/j.sleep.2007.09.008 [doi]
PST - ppublish
SO  - Sleep Med. 2008 Aug;9(6):652-9. doi: 10.1016/j.sleep.2007.09.008. Epub 2007 Nov 
      19.