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Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period
  1. C Philippe1,
  2. M Stoïca-Herman2,
  3. X Drouot2,
  4. B Raffestin3,
  5. P Escourrou4,
  6. L Hittinger5,
  7. P-L Michel6,
  8. S Rouault7,
  9. M-P d’Ortho2
  1. 1Service de Physiologie–Explorations Fonctionnelles, Hôpital Tenon, AP-HP, Paris, France
  2. 2Service de Physiologie–Explorations Fonctionnelles, Hôpital Henri Mondor, AP-HP, Créteil, France
  3. 3Service de Physiologie–Explorations Fonctionnelles, Hôpital Ambroise Paré, AP-HP, Boulogne, France
  4. 4Service de Physiologie–Explorations Fonctionnelles, Hôpital Antoine Béclère, AP-HP, Clamart, France
  5. 5Fédération de Cardiologie, Hôpital Henri Mondor, AP-HP, Créteil, France
  6. 6Service de Cardiologie, Hôpital Tenon, Hôpital Antoine Béclère, Clamart, France
  7. 7ADEP Assistance, Puteaux, France
  1. Correspondence to:
    Professor Marie-Pia d’Ortho
    Service de Physiologie–Explorations Fonctionnelles, Hôpital Henri Mondor, AP-HP, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; marie-pia.dortho{at}creteil.inserm.fr

Abstract

Objective: To compare compliance with and effectiveness of adaptive servoventilation (ASV) versus continuous positive airway pressure (CPAP) in patients with the central sleep apnoea syndrome (CSA) with Cheyne-Stokes respiration (CSR) and with congestive heart failure in terms of the apnoea–hypopnoea index (AHI), quality of life, and left ventricular ejection fraction (LVEF) over six months.

Methods: 25 patients (age 28–80 years, New York Heart Association (NYHA) class II–IV) with stable congestive heart failure and CSA-CSR were randomly assigned to either CPAP or ASV. At inclusion, both groups were comparable for NYHA class, LVEF, medical treatment, body mass index, and CSA-CSR.

Results: Both ASV and CPAP decreased the AHI but, noticeably, only ASV completely corrected CSA-CSR, with AHI below 10/h. At three months, compliance was comparable between ASV and CPAP; however, at six months compliance with CPAP was significantly less than with ASV. At six months, the improvement in quality of life was higher with ASV and only ASV induced a significant increase in LVEF.

Conclusion: These results suggest that patients with CSA-CSR may receive greater benefit from treatment with ASV than with CPAP.

  • AHI, apnoea–hypopnoea index
  • ASV, adaptive servoventilation
  • CHF, congestive heart failure
  • CPAP, continuous positive airway pressure
  • CSA, central sleep apnoea syndrome
  • CSR, Cheyne-Stokes respiration
  • ESS, Epworth sleepiness scale
  • LVEF, left ventricular ejection fraction
  • MWT, maintenance of wakefulness test
  • NYHA, New York Heart Association
  • QOL, quality of life
  • SAS, sleep apnoea syndrome
  • Cheyne-Stokes respiration
  • central sleep apnoea syndrome
  • continuous positive airway pressure
  • adaptive servoventilation
  • heart failure

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Footnotes

  • Published Online First 20 June 2005

  • Competing interests: the study was supported by non-profit organisation funds (ADEP Assistance) and a non-commercial donation made by ResMed France to support research in the Créteil Sleep Laboratory in 2001. CP and M-P d’O were reimbursed by ResMed for travel expenses to attend the American Thoracic Society Annual Conference 2004; SR is employed by ADEP Assistance, which is a non-profit organisation for home care. Other authors have no declared conflict of interest.

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