Beneficial Effects of Adaptive Servo Ventilation in Patients With Chronic Heart Failure

Background: Sleep-disordered breathing (SDB) is thought to be a state of inflammation caused by hypoxic stress. Whether adaptive servo ventilation (ASV) attenuates the inflammatory response and improves the cardiac function of patients with congestive heart failure (CHF) accompanied by SDB was not been investigated. Methods and Results: Seventeen inpatients with New York Heart Association (NYHA) II or III underwent polysomnography. There was a positive correlation between the apnea hypopnea index and high-sensitivity C-reactive protein (hs-CRP) level (r=0.753, P=0.016). The patients were divided into ASV (n=10) and non-ASV groups (n=7), and CHF-parameters were measured before and after ASV treatment. Improvement was noted for the NYHA class in the ASV group but not in the non-ASV group. In contrast to the non-ASV group, the level of brain natriuretic peptide (BNP), ejection fraction, and hs-CRP levels in the ASV group significantly improved (BNP, 212.1 +/- 181.2 to 77.3 +/- 54.0 pg/ml [P<0.05]; ejection fraction, 43.5 +/- 6.4 to 53.3 +/- 6.1% [P=0.002]; hs-CRP, 0.85 +/- 0.58 to 0.21 +/- 0.19 mg/dl, [P=0.008]). The increase in ejection fraction was correlated with a decrease in the hs-CRP level (r=-0.753, P=0.001). Conclusions: Anti-inflammatory effects of ASV are important contributors for improving cardiac function in patients with CHF accompanied by SDB. (Circ J 2010; 74: 2118-2124)