PMID- 36229051 OWN - NLM STAT- MEDLINE DCOM- 20230215 LR - 20230420 IS - 1399-3003 (Electronic) IS - 0903-1936 (Print) IS - 0903-1936 (Linking) VI - 61 IP - 2 DP - 2023 Feb TI - Effect of adaptive servo-ventilation for central sleep apnoea in systolic heart failure on muscle sympathetic nerve activity: a SERVE-HF randomised ancillary study. LID - 10.1183/13993003.00384-2022 [doi] LID - 2200384 AB - BACKGROUND: Adaptive servo-ventilation (ASV) effectively suppresses central sleep apnoea (CSA) but has been associated with increased all-cause and cardiovascular mortality in chronic heart failure patients with reduced ventricular ejection fraction (HFrEF). All-cause and, especially, cardiovascular mortality in chronic heart failure is highly correlated with sympathetic tone. This analysis of SERVE-HF data investigated the effect of ASV on sympathetic tone in patients with HFrEF and CSA. METHODS: HFrEF patients in the SERVE-HF trial (left ventricular ejection fraction (LVEF) /=15 events.h(-1) with predominant CSA) were randomly assigned to receive guideline-based heart failure treatment alone (controls) or plus ASV. For this analysis, the primary outcome was change in muscle sympathetic nerve activity (MSNA) at 3-month follow-up. The effects of baseline MSNA and change in MSNA over time on mortality in the main study were also assessed. RESULTS: 40 patients with HFrEF were included in this analysis (age 71.3+/-11.7 years, LVEF 34.2+/-7.7%, 57.5% in New York Heart Association (NYHA) Functional Class II, 42.5% in NYHA Functional Class III, AHI 35.2+/-11 events.h(-1)). Sympathetic tone evolution during follow-up did not differ between groups (controls: 47.6+/-8.3 bursts.min(-1) at baseline to 44.6+/-11.2 bursts.min(-1); ASV group: 43.0+/-9.0 bursts.min(-1) at baseline to 42.74+/-9.45 bursts.min(-1)). The reduction in sympathetic tone was associated with significantly increased cardiovascular mortality in the ASV group, whereas in the control group reduced sympathetic tone appeared to be protective. CONCLUSIONS: Suppression of CSA with ASV did not seem to have a significant effect on chronic heart failure-related sympathetic activation. Simultaneous suppression of CSA and reduction in MSNA was associated with increased cardiovascular mortality. CI - Copyright (c)The authors 2023. FAU - Tamisier, Renaud AU - Tamisier R AUID- ORCID: 0000-0003-1128-6529 AD - University Grenoble Alpes, HP2, Inserm 1300, Grenoble Alpes University Hospital, Grenoble, France rtamisier@chu-grenoble.fr. AD - Co-first authors. FAU - Pepin, Jean-Louis AU - Pepin JL AD - University Grenoble Alpes, HP2, Inserm 1300, Grenoble Alpes University Hospital, Grenoble, France. AD - Co-first authors. FAU - Woehrle, Holger AU - Woehrle H AD - ResMed Science Center, ResMed Germany, Martinsried, Germany. AD - Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany. FAU - Salvat, Muriel AU - Salvat M AD - Cardiology Clinic, Pole Thorax et Vaisseaux, CHU Grenoble Alpes University Hospital, Grenoble, France. FAU - Barone-Rochette, Gilles AU - Barone-Rochette G AD - INSERM, U1039, Radiopharmaceutiques Biocliniques, University Grenoble Alpes, Department of Cardiology, Grenoble Alpes University Hospital and French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Grenoble, France. FAU - Rocca, Cecile AU - Rocca C AD - Cardiac Re-education Unit, Pole Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France. FAU - Vettorazzi, Eik AU - Vettorazzi E AUID- ORCID: 0000-0002-3737-6402 AD - Department of Medical Biometry and Epidemiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. FAU - Teschler, Helmut AU - Teschler H AD - Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Cowie, Martin AU - Cowie M AD - Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK. AD - Co-senior authors. FAU - Levy, Patrick AU - Levy P AUID- ORCID: 0000-0003-3174-7935 AD - University Grenoble Alpes, HP2, Inserm 1300, Grenoble Alpes University Hospital, Grenoble, France. AD - Co-senior authors. LA - eng SI - ClinicalTrials.gov/NCT00733343 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230209 PL - England TA - Eur Respir J JT - The European respiratory journal JID - 8803460 SB - IM CIN - Eur Respir J. 2023 Feb 9;61(2):. PMID: 36758996 CIN - Eur Respir J. 2023 Mar 9;61(3):. PMID: 36894188 CIN - Eur Respir J. 2023 Mar 9;61(3):. PMID: 36894190 CIN - Eur Respir J. 2023 Apr 20;61(4):. PMID: 37080575 CIN - Eur Respir J. 2023 Apr 20;61(4):. PMID: 37080576 MH - Aged MH - Aged, 80 and over MH - Humans MH - Middle Aged MH - *Heart Failure/complications/therapy MH - *Heart Failure, Systolic/complications/therapy MH - Muscles MH - Respiration MH - *Sleep Apnea, Central/complications/therapy MH - Stroke Volume/physiology MH - Treatment Outcome MH - Ventricular Function, Left/physiology PMC - PMC9909211 COIS- Conflict of interest: R. Tamisier reports lecture fees from ResMed, grant support through his institution from ResMed, Agiradom and Philips, and travel grants from Agiradom. J-L. Pepin reports grant support through his institution from ResMed, Agiradom, Vutalaire and Philips, and travel grants from Agiradom. H. Woehrle reports no conflict of interest. M. Salvat reports no conflict of interest. G. Barone-Rochette reports research grants from Merck Sharp and Dohme, Fondation de France, INSERM, Federation Francaise de Cardiologie and Societe Francaise de Cardiologie, and consulting fees from Bayer. C. Rocca reports no conflict of interest. E. Vettorazzi reports institutional research grants from ResMed. H. Teschler reports no conflict of interest. M. Cowie reports no conflict of interest. P. Levy reports no conflict of interest. EDAT- 2022/10/14 06:00 MHDA- 2023/02/14 06:00 PMCR- 2023/02/09 CRDT- 2022/10/13 20:42 PHST- 2022/02/19 00:00 [received] PHST- 2022/09/18 00:00 [accepted] PHST- 2022/10/14 06:00 [pubmed] PHST- 2023/02/14 06:00 [medline] PHST- 2022/10/13 20:42 [entrez] PHST- 2023/02/09 00:00 [pmc-release] AID - 13993003.00384-2022 [pii] AID - ERJ-00384-2022 [pii] AID - 10.1183/13993003.00384-2022 [doi] PST - epublish SO - Eur Respir J. 2023 Feb 9;61(2):2200384. doi: 10.1183/13993003.00384-2022. Print 2023 Feb.