Auto-servoventilation in heart failure with sleep apnoea: a randomised controlled trial

作者：Arzt Michael^*; Schroll Stephan; Series Frederic; Lewis Keir; Benjamin Amit; Escourrou Pierre; Luigart Ruth; Kehl Victoria; Pfeifer Michael

来源：European Respiratory Journal, 2013, 42(5): 1244-1254.

DOI：10.1183/09031936.00083312

We tested the hypotheses that in patients with congestive heart failure (CUP) and sleep disordered breathing (SDB) auto-servoventilation (ASV) improves cardiac function and quality of life. %26lt;br%26gt;Between March 2007 and September 2009, patients with stable CHF (left ventricular ejection fraction (LVEF) %26lt;= 40%) and SDB (apnoea/hypopnoea index %26gt;= 20 events.h(-1)) were randomised to receive either ASV (BiPAP ASV (Philips Respironics, Murrysville, PA, USA), n=37) and optimal medical management, or optimal medical management alone (n=35). Outcomes were assessed at baseline and 12 weeks. %26lt;br%26gt;The apnoea/hypopnoea index assessed with polysomnography scored in one core laboratory was significantly more reduced in the ASV group (-39 +/- 16 versus -1 +/- 13 events.h(-1); p%26lt;0.001) with an average use of 4.5 +/- 3.0 h.day(-1). Both groups showed similar improvements of the primary end-point LVEF (+3.4 +/- 5 versus + 3.5 +/- 6%; p=0.915) assessed with echocardiography. In the ASV group, reduction of N-terminal probrain natriuretic peptide (NT-proBNP) was significantly greater (-360 +/- 569 versus +135 +/- 625 ng.mL(-1); p=0.010). No differences were observed between the groups in subjective quality of life. %26lt;br%26gt;In patients with CHF and SDB, ASV reduced NT-proBNP levels, but improvement of LVEF or quality of life was not greater than in the control group. The data support that such patients can be randomised in large-scale, long-term trials of positive airway pressure therapy versus control to determine effects on cardiovascular outcome.

• 出版日期2013-11
• 单位河北医科大学