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Adaptive Servo Ventilation

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https://www.readbyqxmd.com/read/28860264/adaptive-servo-ventilation-for-central-sleep-apnoea-in-heart-failure-serve-hf-on-treatment-analysis
#1
Holger Woehrle, Martin R Cowie, Christine Eulenburg, Anna Suling, Christiane Angermann, Marie-Pia d'Ortho, Erland Erdmann, Patrick Levy, Anita K Simonds, Virend K Somers, Faiez Zannad, Helmut Teschler, Karl Wegscheider
This on-treatment analysis was conducted to facilitate understanding of mechanisms underlying the increased risk of all-cause and cardiovascular mortality in heart failure patients with reduced ejection fraction and predominant central sleep apnoea randomised to adaptive servo ventilation versus the control group in the SERVE-HF trial.Time-dependent on-treatment analyses were conducted (unadjusted and adjusted for predictive covariates). A comprehensive, time-dependent model was developed to correct for asymmetric selection effects (to minimise bias)...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28822020/polysomnographic-determinants-of-requirement-for-advanced-positive-pressure-therapeutic-options-for-obstructive-sleep-apnea
#2
Anupama Gupta, Garima Shukla
BACKGROUND: A small percentage of adult patients with severe obstructive sleep apnea (OSA) has been recognized to be extraordinarily difficult to treat with conventional continuous or Bi-level positive airway pressure (together referred to as PAP) therapy. AIM AND OBJECTIVES: The aim of this study was to determine polysomnographic (PSG) characteristics, which may help predict the requirement for advanced therapeutic options for OSA. METHODS: Consecutive patients who underwent PAP titration at our sleep laboratory over a 2-year period were included...
August 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28808861/epidemiology-of-sleep-disordered-breathing-and-heart-failure-what-drives-what
#3
REVIEW
Sushma M Dharia, Lee K Brown
PURPOSE OF REVIEW: The bidirectional relationships that have been demonstrated between heart failure (HF) and central sleep apnea (CSA) demand further exploration with respect to the implications that each condition has for the other. This review discusses the body of literature that has accumulated on these relationships and how CSA and its potential treatment may affect outcomes in patients with CSA. RECENT FINDINGS: Obstructive sleep apnea (OSA) can exacerbate hypertension, type 2 diabetes, obesity, and atherosclerosis, which are known predicates of HF...
August 14, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28777366/-complex-sleep-apnea-syndrome
#4
A D Palman
Complex sleep apnea syndrome (Comp-SAS) is the term used to describe a specific form of sleep disordered breathing characterized by the arise of central sleep apnea in patient with previous obstructive sleep apnea syndrome (OSAS) treated with continuous positive airway pressure devices (CPAP). The mechanisms of its occurrence are not well understood, but partly it seems to be a consequence of increased carbon dioxide elimination under positive airway pressure treatment and related improvement of pulmonary ventilation...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28765411/heart-failure-what-s-new-and-what-s-changed
#5
Paul D Callan, Andrew L Clark
Physicians responsible for the care of patients with heart failure due to left ventricular systolic dysfunction have access to a broad range of evidence-based treatments that prolong life and reduce symptoms. In spite of the significant progress made over the last four decades, there is an ongoing need for novel therapies to treat a condition that is associated with stubbornly high morbidity and mortality. In this article, we discuss the findings of SERVE-HF, a randomised controlled trial of adaptive servo-ventilation in patients with left ventricular systolic dysfunction, as well as EMPA-REG, a study of the effects of a novel diabetic agent that may be of greater interest to heart failure specialists than diabetologists...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28701680/right-ventricular-end-diastolic-pressure-is-a-key-to-the-changes-in-cardiac-output-during-adaptive-servo-ventilation-support-in-patients-with-heart-failure
#6
Teruhiko Imamura, Koichiro Kinugawa
Adaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. ΔLeft ventricular end-diastolic pressure (LVEDP) did not correlate with ΔCI, whereas Δtransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and ΔCI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28697252/association-of-positive-airway-pressure-with-cardiovascular-events-and-death-in-adults-with-sleep-apnea-a-systematic-review-and-meta-analysis
#7
REVIEW
Jie Yu, Zien Zhou, R Doug McEvoy, Craig S Anderson, Anthony Rodgers, Vlado Perkovic, Bruce Neal
Importance: Sleep apnea (obstructive and central) is associated with adverse cardiovascular risk factors and increased risks of cardiovascular disease. Positive airway pressure (PAP) provides symptomatic relief, whether delivered continuously (CPAP) or as adaptive servo-ventilation (ASV), but the associations with cardiovascular outcomes and death are unclear. Objective: To assess the association of PAP vs control with cardiovascular events and death in patients with sleep apnea...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28671174/case-of-postural-complex-sleep-apnea-effect-of-gravitational-forces
#8
Kamender Singh Pawar, Abhishek Goyal, Alkesh Khurana, Senthil Kumar, Amit Kumar Sen
We report a case of an elderly male with predominant obstructive sleep apnea and who developed or complex sleep apnea (CxSA) at the start of continuous positive airway pressure (CPAP) titration. This CxSA was more prominent in supine position, and he was not settling with either CPAP/bilevel positive airway pressure (PAP) in supine position. He finally settled with CPAP along with position therapy. This case highlights the importance of treating CxSA with basic PAP modes like CPAP along with positional therapy before switching to costlier therapies such as adaptive servo-ventilation...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28653420/impact-of-endotracheal-tube-shortening-on-work-of-breathing-in-neonatal-and-pediatric-in-vitro-lung-models
#9
Rebecca Mohr, Jörg Thomas, Vincenzo Cannizzaro, Markus Weiss, Alexander R Schmidt
BACKGROUND: Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. AIM: The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28637078/-update-cardiovascular-sleep-medicine
#10
REVIEW
Benedikt Linz, Michael Böhm, Dominik Linz
The prevalence of sleep-disordered breathing (SDB) is high in patients with cardiovascular diseases. Typical symptoms like daytime sleepiness can be absent and those patients may report unspecific, therapy-resistant symptoms related to their underlying disease. Particularly sleep-related symptoms like nocturia, nocturnal dyspnea and pectangina can be present. Based on the results of recently published studies, the treatment of central sleep apnea in patients with symptomatic, systolic heart failure by adaptive servo-ventilation is no longer recommended...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#11
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
June 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28484123/adaptive-servo-ventilation-treatment-increases-stroke-volume-in-stable-systolic-heart-failure-patients-with-low-tricuspid-annular-plane-systolic-excursion
#12
Toshihiro Iwasaku, Tomotaka Ando, Akiyo Eguchi, Yoshitaka Okuhara, Yoshiro Naito, Toshiaki Mano, Tohru Masuyama, Shinichi Hirotani
We hypothesized that the effects of adaptive servo-ventilation (ASV) therapy were influenced by right-sided heart performance. This study aimed to clarify the interaction between the effects of ASV and right-sided heart performance in patients with stable heart failure (HF) with reduced ejection fraction (HFrEF).Twenty-six stable HF inpatients (left ventricular ejection fraction < 0.45, without moderate to severe mitral regurgitation (MR) were analyzed. Echocardiography was performed before and after 30 minutes of ASV...
May 31, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28452842/adaptive-servo-ventilation-in-heart-failure
#13
Ana Pais, Luiz Menezes Falcão
No abstract text is available yet for this article.
April 25, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28417254/whom-are-we-treating-with-adaptive-servo-ventilation-a-clinical-post-hoc-analysis
#14
Maximilian V Malfertheiner, C Lerzer, L Kolb, K Heider, F Zeman, F Gfüllner, L S Maier, M Pfeifer, M Arzt
BACKGROUND: Recent evidence has shown that adaptive servo-ventilation (ASV) is contraindicated in patients with predominant central sleep apnea (CSA) and reduced left ventricular ejection fraction (LVEF ≤45%). The objective of this study was to assess the clinical usage of ASV in patients at the time-point of the release of a safety warning by type of SDB, breathing pattern and LVEF. METHODS: Patients of a cardiac and a respirology sleep center, both in Germany, who received ASV therapy were contacted between May and October 2015...
April 17, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28390743/adaptive-servo-ventilation-therapy-reduces-hospitalization-rate-in-patients-with-severe-heart-failure
#15
Masayoshi Yoshida, Shin-Ichi Ando, Kazuhisa Kodama, Kie Ebihara, Kaoru Tanaka, Atsumi Hayashi, Eiji Taguchi, Toshiaki Kadokami, Kouichi Nakao, Tomohiro Sakamoto
INTRODUCTION: Adaptive servo-ventilation (ASV) therapy is a recently developed non-pharmacological therapy that has been reported to improve cardiac function and survival in patients with severe congestive heart failure (CHF). However, a recent large randomized study suggested that ASV does not improve survival in patients with reduced ejection fraction. It remains unclear whether ASV treatment can reduce the hospitalization rate of CHF patients. We thus examined the frequency of hospital admission before and after initiation of ASV therapy in patients with CHF...
July 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28371141/design-of-the-effect-of-adaptive-servo-ventilation-on-survival-and-cardiovascular-hospital-admissions-in-patients-with-heart-failure-and-sleep-apnoea-the-advent-hf-trial
#16
Owen D Lyons, John S Floras, Alexander G Logan, Robert Beanlands, Joaquin Durán Cantolla, Michael Fitzpatrick, John Fleetham, R John Kimoff, Richard S T Leung, Geraldo Lorenzi Filho, Pierre Mayer, Lisa Mielniczuk, Debra L Morrison, Clodagh M Ryan, Frederic Series, George A Tomlinson, Anna Woo, Michael Arzt, Sairam Parthasarathy, Stefania Redolfi, Takatoshi Kasai, Gianfranco Parati, Diego H Delgado, T Douglas Bradley
INTRODUCTION: Both types of sleep-disordered breathing (SDB), obstructive and central sleep apnoea (OSA and CSA, respectively), are common in patients with heart failure and reduced ejection fraction (HFrEF). In such patients, SDB is associated with increased cardiovascular morbidity and mortality but it remains uncertain whether treating SDB by adaptive servo-ventilation (ASV) in such patients reduces morbidity and mortality. AIM: ADVENT-HF is designed to assess the effects of treating SDB with ASV on morbidity and mortality in patients with HFrEF...
April 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28335841/cardiovascular-outcomes-with-minute%C3%A2-ventilation-targeted-adaptive-servo-ventilation-therapy-in-heart-failure-the-cat-hf-trial
#17
RANDOMIZED CONTROLLED TRIAL
Christopher M O'Connor, David J Whellan, Mona Fiuzat, Naresh M Punjabi, Gudaye Tasissa, Kevin J Anstrom, Adam V Benjafield, Holger Woehrle, Amy B Blase, JoAnn Lindenfeld, Olaf Oldenberg
BACKGROUND: Sleep apnea is common in hospitalized heart failure (HF) patients and is associated with increased morbidity and mortality. OBJECTIVES: The CAT-HF (Cardiovascular Improvements With MV-ASV Therapy in Heart Failure) trial investigated whether minute ventilation (MV) adaptive servo-ventilation (ASV) improved cardiovascular outcomes in hospitalized HF patients with moderate-to-severe sleep apnea. METHODS: Eligible patients hospitalized with HF and moderate-to-severe sleep apnea were randomized to ASV plus optimized medical therapy (OMT) or OMT alone (control)...
March 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28320992/right-ventricular-enlargement-and-renal-function-are-associated-with-smooth-introduction-of-adaptive-servo-ventilation-therapy-in-chronic-heart-failure-patients
#18
Toshihiro Iwasaku, Yoshitaka Okuhara, Akiyo Eguchi, Tomotaka Ando, Yoshiro Naito, Tohru Masuyama, Shinichi Hirotani
Although adaptive servo-ventilation (ASV) therapy has beneficial effects on chronic heart failure (CHF), a relatively large number of CHF patients cannot undergo ASV therapy due to general discomfort from the mask and/or positive airway pressure. The present study aimed to clarify baseline patient characteristics which are associated with the smooth introduction of ASV treatment in stable CHF inpatients.Thirty-two consecutive heart failure (HF) inpatients were enrolled (left ventricular ejection fraction (LVEF) < 45%, estimated glomerular filtration rate (eGFR) > 10 mL/minute/1...
April 6, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28210325/hot-topics-from-the-assemblies
#19
(no author information available yet)
Cowie et al. present the results of the international, multicentre, randomised, parallel-group SERVE-HF (Treatment of sleep-disordered breathing with predominant central sleep apnea by adaptive servo ventilation in patients with heart failure) trial, which investigated the effects of adding adaptive servo-ventilation (ASV) to guideline based medical management on survival and cardiovascular outcomes in patients with heart failure defined as reduced ejection fraction (<45%) and predominant central sleep apnoea (CSA)...
December 2016: Breathe
https://www.readbyqxmd.com/read/28188451/patients-with-cheyne-stokes-respiration-and-heart-failure-patient-tolerance-after-three-month-discontinuation-of-treatment-with-adaptive-servo-ventilation
#20
Arild Hetland, Tøri Vigeland Lerum, Kristina H Haugaa, Thor Edvardsen
The recent SERVE HF study concluded that patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) have increased mortality when treated with adaptive servo-ventilation (ASV). We, therefore, wanted to explore if these patients tolerated discontinuation of ASV treatment. The study was a prospective post-ASV treatment observational design with a 3-month follow-up period. 14 patients from our outpatient clinic, all male, were originally diagnosed with CHF and Cheyne-Stokes respiration, which is a clinical form of central sleep apnea...
August 2017: Heart and Vessels
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