PMID- 33524864
OWN - NLM
STAT- MEDLINE
DCOM- 20210421
LR  - 20210421
IS  - 1527-3288 (Electronic)
IS  - 0147-9563 (Linking)
VI  - 50
IP  - 2
DP  - 2021 Mar-Apr
TI  - Therapeutic value of treating central sleep apnea by adaptive servo-ventilation 
      in patients with heart failure: A systematic review and meta-analysis.
PG  - 344-351
LID - S0147-9563(21)00012-1 [pii]
LID - 10.1016/j.hrtlng.2021.01.012 [doi]
AB  - BACKGROUND: Despite the efficacy of adaptive servo-ventilation (ASV) in 
      suppressing central sleep apnea (CSA), its impact on long-term outcomes is 
      debatable. We aim to identify subjects with specific features who might benefit 
      from ASV therapy. METHODS: Randomized clinical trials and comparative 
      observational studies investigating the effects of ASV on cardiovascular (CV) and 
      all-cause mortality and major adverse cardiovascular events (MACEs) in CSA 
      patients were searched from PubMed, EMBASE, Cochrane library and Web of Science. 
      Eligible studies were identified with relative risks (RR) of death and MACEs 
      compared between patients treated by ASV and usual care. RESULTS: A total of 
      eight studies (three randomized controlled trials and five observational studies) 
      including 2208 participants were selected for analysis. All-cause and CV 
      mortality were not significantly reduced by ASV. Patients with nadir nocturnal 
      saturation </= 80% (mean value) had lower risk of MACEs by ASV treatment compared 
      with by usual care (RR, 0.18; p < 0.001). Patients with severe heart failure 
      (HF), defined as left ventricular ejection fraction (LVEF) </= 33% (mean value), or 
      HF of New York Heart Association (NYHA) classification of III/IV, did not have 
      reduced risk of MACEs post ASV therapy. However, subjects with LVEF > 33% (RR, 
      0.35; p < 0.001) or NYHA Ⅰ/Ⅱ (RR, 0.35; p < 0.001) had significantly lower risk 
      of MACEs by using ASV than by usual care. CONCLUSIONS: Although ASV appears to 
      not reduce CV and all-cause death for HF patients with extremely low LVEF, those 
      with profound CSA associated hypoxemia or less severe HF still benefit from ASV 
      therapy.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Wang, Jingting
AU  - Wang J
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Covassin, Naima
AU  - Covassin N
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
FAU - Dai, Tianxin
AU  - Dai T
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Fan, Zhengyang
AU  - Fan Z
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Yisilamu, Patiguli
AU  - Yisilamu P
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Sun, Dance
AU  - Sun D
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Li, Fei
AU  - Li F
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China.
FAU - Xie, Jiang
AU  - Xie J
AD  - Department of Respiratory and Critical Medicine of Beijing Anzhen Hospital, 
      Capital Medical University, Beijing, China. Electronic address: 
      frank782008@aliyun.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20210201
PL  - United States
TA  - Heart Lung
JT  - Heart & lung : the journal of critical care
JID - 0330057
SB  - IM
MH  - *Heart Failure/therapy
MH  - Humans
MH  - New York
MH  - Randomized Controlled Trials as Topic
MH  - *Sleep Apnea, Central/etiology/therapy
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Adaptive servo-ventilation
OT  - Central sleep apnea
OT  - Heart failure
OT  - Major adverse cardiovascular events
COIS- Declaration of Competing Interest The authors declare the following financial 
      interests/personal relationships which may be considered as potential competing 
      interests: Dr. Xie has served as a consultant for ResMed and Philips. He has 
      spoken at meetings sponsored by Philips and ResMed. All other authors have 
      reported that they have no relationships relevant to the contents of this paper 
      to disclose.
EDAT- 2021/02/02 06:00
MHDA- 2021/04/22 06:00
CRDT- 2021/02/01 20:17
PHST- 2020/08/04 00:00 [received]
PHST- 2021/01/05 00:00 [revised]
PHST- 2021/01/19 00:00 [accepted]
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2021/04/22 06:00 [medline]
PHST- 2021/02/01 20:17 [entrez]
AID - S0147-9563(21)00012-1 [pii]
AID - 10.1016/j.hrtlng.2021.01.012 [doi]
PST - ppublish
SO  - Heart Lung. 2021 Mar-Apr;50(2):344-351. doi: 10.1016/j.hrtlng.2021.01.012. Epub 
      2021 Feb 1.