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

TLDR

The study compared compliance and effectiveness of adaptive servoventilation (ASV) versus continuous positive airway pressure (CPAP) in heart‑failure patients with central sleep apnoea and Cheyne‑Stokes respiration over six months, assessing apnoea‑hypopnoea index, quality of life, and left ventricular ejection fraction. Twenty‑five stable CHF patients (age 28–80, NYHA II–IV) with CSA‑CSR were randomized to receive either CPAP or ASV. ASV lowered AHI below 10/h, fully corrected CSA‑CSR, improved quality of life, and increased LVEF, whereas CPAP only reduced AHI and had lower compliance at six months, indicating ASV offers greater benefit for CSA‑CSR in heart‑failure patients.

Abstract

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