PMID- 25103691
OWN - NLM
STAT- MEDLINE
DCOM- 20160915
LR  - 20211021
IS  - 1615-2573 (Electronic)
IS  - 0910-8327 (Print)
IS  - 0910-8327 (Linking)
VI  - 30
IP  - 6
DP  - 2015 Nov
TI  - Adaptive servo-ventilation therapy using an innovative ventilator for patients 
      with chronic heart failure: a real-world, multicenter, retrospective, 
      observational study (SAVIOR-R).
PG  - 805-17
LID - 10.1007/s00380-014-0558-8 [doi]
AB  - Adaptive servo-ventilation (ASV) therapy using an innovative 
      ventilator-originally developed to treat sleep-disordered breathing (SDB)-is a 
      novel modality of noninvasive positive pressure ventilation and is gaining 
      acceptance among Japanese cardiologists in expectation of its applicability to 
      treat patients with chronic heart failure (CHF) based on its acute beneficial 
      hemodynamic effects. We conducted a multicenter, retrospective, real-world 
      observational study in 115 Japanese patients with CHF, who had undergone home ASV 
      therapy for the first time from January through December 2009, to examine their 
      profile and the effects on their symptoms and hemodynamics. Medical records were 
      used to investigate New York Heart Association (NYHA) class, echocardiographic 
      parameters including left ventricular ejection fraction (LVEF), cardiothoracic 
      ratio (CTR), brain natriuretic peptide (BNP), and other variables. Most of the 
      patients were categorized to NYHA classes II (44.4 %) and III (40.7 %). SDB 
      severity was not determined in 44 patients, and SDB was not detected or was mild 
      in 27 patients. In at least 71 patients (61.7 %), therefore, ASV therapy was not 
      applied for the treatment of SDB. CHF was more severe, i.e., greater NYHA class, 
      lower LVEF, and higher CTR, in 87 ASV-continued patients (75.7 %) than in 28 
      ASV-discontinued patients (24.3 %). However, SDB severity was not related to 
      continuity of ASV. The combined proportion of NYHA classes III and IV (P = 0.012) 
      and LVEF (P = 0.009) improved significantly after ASV therapy. CTR and BNP did 
      not improve significantly after ASV therapy but showed significant beneficial 
      changes in their time-course analysis (P < 0.05, respectively). Improvements in 
      LVEF and NYHA class after ASV therapy were not influenced by SDB severity at 
      onset. The present study suggests that ASV therapy would improve the symptoms and 
      hemodynamics of CHF patients, regardless of SDB severity. A randomized clinical 
      study to verify these effects is warranted.
FAU - Momomura, Shin-Ichi
AU  - Momomura S
AD  - Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 
      Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan. momochan-tky@umin.ac.jp.
FAU - Seino, Yoshihiko
AU  - Seino Y
AD  - Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 
      Japan.
FAU - Kihara, Yasuki
AU  - Kihara Y
AD  - Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan.
FAU - Adachi, Hitoshi
AU  - Adachi H
AD  - Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
FAU - Yasumura, Yoshio
AU  - Yasumura Y
AD  - Cardiovascular Division, Osaka National Hospital, Osaka, Japan.
FAU - Yokoyama, Hiroyuki
AU  - Yokoyama H
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140808
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Body Weight
MH  - Chronic Disease
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/*complications
MH  - Hemodynamics
MH  - Humans
MH  - Japan
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Natriuretic Peptide, Brain/blood
MH  - Positive-Pressure Respiration/*instrumentation
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Sleep Apnea Syndromes/*therapy
MH  - Treatment Outcome
MH  - *Ventilators, Mechanical
MH  - Ventricular Function, Left
PMC - PMC4648955
OTO - NOTNLM
OT  - Adaptive servo-ventilation
OT  - Cardiac function
OT  - Chronic heart failure
OT  - Noninvasive positive pressure ventilation
OT  - Sleep-disordered breathing
EDAT- 2014/08/12 06:00
MHDA- 2016/09/16 06:00
PMCR- 2014/08/08
CRDT- 2014/08/09 06:00
PHST- 2014/03/05 00:00 [received]
PHST- 2014/07/11 00:00 [accepted]
PHST- 2014/08/09 06:00 [entrez]
PHST- 2014/08/12 06:00 [pubmed]
PHST- 2016/09/16 06:00 [medline]
PHST- 2014/08/08 00:00 [pmc-release]
AID - 10.1007/s00380-014-0558-8 [pii]
AID - 558 [pii]
AID - 10.1007/s00380-014-0558-8 [doi]
PST - ppublish
SO  - Heart Vessels. 2015 Nov;30(6):805-17. doi: 10.1007/s00380-014-0558-8. Epub 2014 
      Aug 8.