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
- C Philippe1,
- M Stoïca-Herman2,
- X Drouot2,
- B Raffestin3,
- P Escourrou4,
- L Hittinger5,
- P-L Michel6,
- S Rouault7,
- M-P d’Ortho2
- 1Service de Physiologie–Explorations Fonctionnelles, Hôpital Tenon, AP-HP, Paris, France
- 2Service de Physiologie–Explorations Fonctionnelles, Hôpital Henri Mondor, AP-HP, Créteil, France
- 3Service de Physiologie–Explorations Fonctionnelles, Hôpital Ambroise Paré, AP-HP, Boulogne, France
- 4Service de Physiologie–Explorations Fonctionnelles, Hôpital Antoine Béclère, AP-HP, Clamart, France
- 5Fédération de Cardiologie, Hôpital Henri Mondor, AP-HP, Créteil, France
- 6Service de Cardiologie, Hôpital Tenon, Hôpital Antoine Béclère, Clamart, France
- 7ADEP Assistance, Puteaux, France
- 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
- Accepted 9 June 2005
- Published Online First 17 June 2005
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
Footnotes
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Published Online First 20 June 2005
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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.
