Three-Month Treatment with Adaptive Servoventilation Improves Cardiac Function and Physical Activity in Patients with Chronic Heart Failure and Cheyne-Stokes Respiration: A Prospective Randomized Controlled Trial

Background: Cheyne-Stokes respiration frequently occurs in patients with congestive heart failure (CHF). Adaptive servoventilation (ASV) is a novel therapy with potential benefits. This prospective randomized trial investigated the effects of ASV on myocardial function and physical capacity. Methods: Patients with severe CHF, despite optimal cardiac medication and/or left ventricular ejection fraction (LVEF) <= 40% and Cheyne-Stokes breathing for > 25% of sleeping time were included. Fifty-one patients, age 57-81 years (4 were women), were randomized to either an ASV or a control group; 30 patients completed the study (15 from each group). The primary end point was any change in LVEF. The secondary end points were alterations in physical capacity according to the 6-min walk test or the New York Heart Association (NYHA) class. Results: In the ASV-treatment group, LVEF improved from baseline (32 +/- 11%) to study end (36 +/- 13%), p = 0.013. The 6-min walk test improved from 377 +/- 115 to 430 +/- 123 m (p = 0.014) and the NYHA class from 3.2 (3.0-3.0) to 2.0 (2.0-3.0) (p < 0.001). No changes occurred in the control group. Conclusion: Three months of ASV treatment improved LVEF and physical capacity in CHF patients with Cheyne-Stokes respiration. These results suggest that ASV may be a beneficial supplement to standard medication in these patients. (C) 2013 S. Karger AG, Basel