期刊
JOURNAL OF CARDIOVASCULAR MEDICINE
卷 14, 期 4, 页码 296-300出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.2459/JCM.0b013e32835364b2
关键词
central sleep apnea; chronic heart failure; heart rate; heart rate variability; oxygen saturation; sympathetic nervous system
Aim Adaptive servo ventilation (ASV) is a method of ventilator support aimed to treat central sleep apnea (CSA). We investigated the effects of an acute use of ASV in chronic heart failure (CHF) patients with CSA and the potential influence on sympathetic nerve activity. Methods Patients were studied with ambulatory cardiorespiratory 24 Holter (Somte) recording of air flow, ECG and oxygen saturation. Comparison before and after ASV treatment was made for apnea index (AI), apnea-hypopnea index (AHI), pulse oxygen saturation, desaturation related to apnea, heart rate (HR) and heart rate variability (HRV). Results Seventeen patients were enrolled. At baseline, apnea index and apnea-hypopnea index were, respectively, 16.92 +/- 7.8 and 41.37 +/- 17.5. During ASV, they significantly decreased to 0.06 +/- 0.0 (P<0.001) and 2.84 +/- 1.1 (P<0.001). The mean and minimal oxygen saturation (%) increased from 94 +/- 1 and 86.5 +/- 4 to 95 +/- 2 (P=0.04) and 91 +/- 2 (P=0.008). Mean HR decreased from 68 +/- 10 to 62 +/- 7 beats/min (P<0.003). In 11 out of 17 patients, HRV was calculated, documenting a significant improvement of the standard deviation of the average of NN - normal sinus to normal sinus (SDANN), standard deviation of NN intervals (SDNN) and SDNN index (respectively, 71.5 +/- 31.1 vs. 80.4 +/- 36.1, P=0.008; 99.7 +/- 31.3 vs. 112.7 +/- 37.5, P=0.003; 57.8 +/- 20.7 vs. 69.3 +/- 30.8, P=0.03). Conclusion The acute use of ASV is effective on CSA by increasing oxygen saturation and reducing HR. Moreover, the significant improvement of HRV highlights ASV's benefit in moderating the sympathetic adrenergic tone.
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