Beneficial effects of adaptive servo-ventilation on natriuretic peptides and diastolic function in acute heart failure patients with preserved ejection fraction and sleep-disordered breathing

E. D’Elia, P. Ferrero, C. Vittori, A. Iacovoni, A. Grosu, M. Gori, V. Duino, S. Perlini, Michele Senni

Research output: Contribution to journalArticle

Abstract

Purpose: Adaptive servo-ventilation (ASV) is a ventilator algorithm able to correct breathing through anticyclic support of breathing in patients with central sleep apnea (CSA). So far, very few data exist regarding the role of ASV on acute heart failure with preserved ejection fraction (HFpEF). Methods: We performed a single-center prospective, randomized, case-control study in consecutive acute HFpEF (left ventricle ejection fraction, LVEF ≥ 45%) patients with sleep-disordered breathing (SDB, apnea–hypopnea index, AHI > 15/h) and prevalence of CSA. Results: We included ten consecutive patients randomized for ASV on top of standard therapy for acute heart failure (group 1) versus standard care alone (group 2). ASV therapy significantly reduced AHI and CSA. An improvement in cardiac diastolic function was seen in group 1 compared to group 2 (E/E’ 17.5 to 9.6, p < 0.02 vs 18.5 to 14.5, p = 0.4). Brain natriuretic peptide (BNP) markedly decreased in cases, but not in controls (298 to 84 pg/ml, p < 0.02 vs 280 to 120 pg/ml, p = 0.06). Right ventricle (RV) function significantly improved in group 1, differently from group 2. Conclusions: An acute use of ASV seems effective in reducing BNP and improving diastolic and RV function in acute HFpEF patients with SDB and CSA, compared to standard treatment.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalSleep and Breathing
DOIs
Publication statusAccepted/In press - Jun 15 2018
Externally publishedYes

Fingerprint

Natriuretic Peptides
Sleep Apnea Syndromes
Central Sleep Apnea
Ventilation
Heart Failure
Heart Ventricles
Brain Natriuretic Peptide
Respiration
Mechanical Ventilators
Case-Control Studies
Therapeutics

Keywords

  • Adaptive servo-ventilation
  • Central sleep apnea
  • Diastolic function
  • Heart failure with preserved ejection fraction
  • Right ventricle

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology

Cite this

Beneficial effects of adaptive servo-ventilation on natriuretic peptides and diastolic function in acute heart failure patients with preserved ejection fraction and sleep-disordered breathing. / D’Elia, E.; Ferrero, P.; Vittori, C.; Iacovoni, A.; Grosu, A.; Gori, M.; Duino, V.; Perlini, S.; Senni, Michele.

In: Sleep and Breathing, 15.06.2018, p. 1-5.

Research output: Contribution to journalArticle

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AU - Ferrero, P.

AU - Vittori, C.

AU - Iacovoni, A.

AU - Grosu, A.

AU - Gori, M.

AU - Duino, V.

AU - Perlini, S.

AU - Senni, Michele

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N2 - Purpose: Adaptive servo-ventilation (ASV) is a ventilator algorithm able to correct breathing through anticyclic support of breathing in patients with central sleep apnea (CSA). So far, very few data exist regarding the role of ASV on acute heart failure with preserved ejection fraction (HFpEF). Methods: We performed a single-center prospective, randomized, case-control study in consecutive acute HFpEF (left ventricle ejection fraction, LVEF ≥ 45%) patients with sleep-disordered breathing (SDB, apnea–hypopnea index, AHI > 15/h) and prevalence of CSA. Results: We included ten consecutive patients randomized for ASV on top of standard therapy for acute heart failure (group 1) versus standard care alone (group 2). ASV therapy significantly reduced AHI and CSA. An improvement in cardiac diastolic function was seen in group 1 compared to group 2 (E/E’ 17.5 to 9.6, p < 0.02 vs 18.5 to 14.5, p = 0.4). Brain natriuretic peptide (BNP) markedly decreased in cases, but not in controls (298 to 84 pg/ml, p < 0.02 vs 280 to 120 pg/ml, p = 0.06). Right ventricle (RV) function significantly improved in group 1, differently from group 2. Conclusions: An acute use of ASV seems effective in reducing BNP and improving diastolic and RV function in acute HFpEF patients with SDB and CSA, compared to standard treatment.

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