PMID- 23453905
OWN - NLM
STAT- MEDLINE
DCOM- 20131217
LR  - 20130429
IS  - 1878-5506 (Electronic)
IS  - 1389-9457 (Linking)
VI  - 14
IP  - 5
DP  - 2013 May
TI  - Trilevel adaptive servoventilation for the treatment of central and mixed sleep 
      apnea in chronic heart failure patients.
PG  - 422-7
LID - S1389-9457(13)00009-9 [pii]
LID - 10.1016/j.sleep.2012.12.013 [doi]
AB  - BACKGROUND: Sleep-disordered breathing (SDB) in patients with heart failure (HF) 
      is of major prognostic impact, though treatment of simultaneously occurring 
      central and mixed apnea events is challenging. The objective was to examine 
      long-term effects of a new trilevel adaptive servoventilation (ASV) therapy in 
      patients with systolic or diastolic HF. METHODS: A total of 45 consecutive 
      patients with a history of HF, elevated N-terminal prohormone of brain 
      natriuretic peptide levels, objective signs of cardiac dysfunction, and moderate 
      to severe SDB (apnea-hypopnea index [AHI] > or =15/h) with combined central and 
      mixed respiratory events were included in this study and ASV therapy (SOMNOvent 
      CR, Weinmann) was offered. RESULTS: In 38 patients (84%), ASV therapy was 
      successfully initiated, with 23 (51%) patients showing appropriate compliance 
      (device use > or = 4 h/night for > or = 5d/w) after 3.6+/-1.2 months. In these 
      patients ASV therapy and HF status were re-evaluated. A sustained reduction was 
      achieved in AHI (42.8+/-17.5/h vs 8.9+/-5.8/h; p<0.001) and oxygen saturation. 
      Improvements also were recorded in New York Heart Association (NYHA) functional 
      class (2.4+/-0.5-1.9+/-0.4; p<0.001) and oxygen uptake during cardiopulmonary 
      exercise testing (VO2 peak, 13.64+/-3.5-15.8+/-5.8 ml/kg/min; p<0.002). CONCLUSION: 
      In selected HF patients, trilevel ASV therapy is able to treat SDB with combined 
      central and mixed respiratory events. This treatment is associated with an 
      improvement in HF symptoms and objective cardiopulmonary performance.
CI  - Copyright (c) 2013 Elsevier B.V. All rights reserved.
FAU - Oldenburg, Olaf
AU  - Oldenburg O
AD  - Dept. of Cardiology, Heart and Diabetes Centre North Rhine Westphalia, Ruhr 
      University Bochum, Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de
FAU - Bitter, Thomas
AU  - Bitter T
FAU - Wellmann, Birgit
AU  - Wellmann B
FAU - Fischbach, Thomas
AU  - Fischbach T
FAU - Efken, Christina
AU  - Efken C
FAU - Schmidt, Anke
AU  - Schmidt A
FAU - Horstkotte, Dieter
AU  - Horstkotte D
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20130301
PL  - Netherlands
TA  - Sleep Med
JT  - Sleep medicine
JID - 100898759
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cheyne-Stokes Respiration/complications/therapy
MH  - Chronic Disease
MH  - Continuous Positive Airway Pressure/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Diastolic/*complications
MH  - Heart Failure, Systolic/*complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Sleep Apnea Syndromes/*complications/*therapy
MH  - Treatment Outcome
EDAT- 2013/03/05 06:00
MHDA- 2013/12/18 06:00
CRDT- 2013/03/05 06:00
PHST- 2012/06/20 00:00 [received]
PHST- 2012/12/12 00:00 [revised]
PHST- 2012/12/15 00:00 [accepted]
PHST- 2013/03/05 06:00 [entrez]
PHST- 2013/03/05 06:00 [pubmed]
PHST- 2013/12/18 06:00 [medline]
AID - S1389-9457(13)00009-9 [pii]
AID - 10.1016/j.sleep.2012.12.013 [doi]
PST - ppublish
SO  - Sleep Med. 2013 May;14(5):422-7. doi: 10.1016/j.sleep.2012.12.013. Epub 2013 Mar 
      1.