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Adaptive servo-ventilation

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https://www.readbyqxmd.com/read/29218014/acute-effects-of-positive-airway-pressure-on-functional-mitral-regurgitation-in-patients-with-systolic-heart-failure
#1
Takao Kato, Takatoshi Kasai, Shoichiro Yatsu, Azusa Murata, Hiroki Matsumoto, Shoko Suda, Masaru Hiki, Nanako Shiroshita, Mitsue Kato, Fusae Kawana, Sakiko Miyazaki, Hiroyuki Daida
Background: Acute effects of positive airway pressure (PAP) [including continuous PAP (CPAP) and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR) in patients with heart failure (HF) with left ventricular (LV) systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated. Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF) <50% (14 men; mean LVEF, 35...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29200833/positive-airway-pressure-adherence-and-subthreshold-adherence-in-posttraumatic-stress-disorder-patients-with-comorbid-sleep-apnea
#2
Barry J Krakow, Jessica J Obando, Victor A Ulibarri, Natalia D McIver
Study objectives: Patients with comorbid posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) manifest low adherence to continuous positive airway pressure (CPAP) due to fixed, pressure-induced expiratory pressure intolerance (EPI), a subjective symptom and objective sign aggravated by anxiety sensitivity and somatosensory amplification. As advanced PAP therapy modes (ie, auto-bilevel PAP [ABPAP] or adaptive servo-ventilation [ASV]) may address these side effects, we hypothesized such treatment would be associated with decreased expiratory intolerance and increased adherence in posttraumatic stress patients with co-occurring OSA...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29193576/adaptive-servo-ventilation-for-central-sleep-apnoea-in-systolic-heart-failure-results-of-the-major-substudy-of-serve-hf
#3
Martin R Cowie, Holger Woehrle, Karl Wegscheider, Eik Vettorazzi, Susanne Lezius, Wolfgang Koenig, Frank Weidemann, Gillian Smith, Christiane Angermann, Marie-Pia d'Ortho, Erland Erdmann, Patrick Levy, Anita K Simonds, Virend K Somers, Faiez Zannad, Helmut Teschler
AIMS: The SERVE-HF trial investigated the impact of treating central sleep apnoea (CSA) with adaptive servo-ventilation (ASV) in patients with systolic heart failure. A preplanned substudy was conducted to provide insight into mechanistic changes underlying the observed effects of ASV, including assessment of changes in left ventricular function, ventricular remodelling, and cardiac, renal and inflammatory biomarkers. METHODS AND RESULTS: In a subset of the 1325 randomised patients, echocardiography, cardiac magnetic resonance imaging (cMRI) and biomarker analysis were performed at baseline, and 3 and 12 months...
November 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29181786/early-therapeutic-effects-of-adaptive-servo-ventilation-on-cardiac-sympathetic-nervous-function-in-patients-with-heart-failure-evaluated-using-a-combination-of-11c-hed-pet-and-123i-mibg-spect
#4
Yusuke Tokuda, Mamoru Sakakibara, Keiichiro Yoshinaga, Shiro Yamada, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Keiji Noguchi, Osamu Manabe, Nagara Tamaki, Hiroyuki Tsutsui
RATIONALE: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57...
November 27, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29174288/-update-on-the-respiratory-management-of-patients-with-chronic-neuromuscular-disease
#5
REVIEW
P Priou, W Trzepizur, N Meslier, F Gagnadoux
BACKGROUND: Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). SURVEILLANCE AND PULMONARY FUNCTION TESTS: For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency...
November 21, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29162360/sleep-disordered-breathing-in-heart-failure-the-state-of-the-art-after-the-serve-hf-trial
#6
REVIEW
João Carmo, Inês Araújo, Filipa Marques, Cândida Fonseca
Heart failure (HF) is one of the most prevalent conditions worldwide and despite therapeutic advances, its prognosis remains poor. Among the multiple comorbidities in HF, sleep-disordered breathing (SDB) is frequent and worsens the prognosis. Preliminary observational studies suggested that treatment of SDB could modify the prognosis of HF, and the issue has gained importance in recent years. The diagnosis of SDB is expensive, slow and suboptimal, and there is thus a need for screening devices that are easier to use and validated in this population...
November 18, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29108606/positive-airway-pressure-device-technology-past-and-present-what-s-in-the-black-box
#7
REVIEW
Lee K Brown, Shahrokh Javaheri
Since the introduction of continuous positive airway pressure (PAP) for the treatment of obstructive sleep apnea (OSA) in 1981, PAP technology has diversified exponentially. Compact and quiet fixed continuous PAP flow generators, autotitrating PAP devices, and bilevel PAP devices that can treat multiple sleep-disordered breathing phenotypes including OSA, central sleep apnea (CSA), combinations of OSA and CSA, and hypoventilation are available. Adaptive servo-ventilators can suppress Hunter-Cheyne-Stokes breathing and CSA and treat coexisting obstructive events...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28860264/adaptive-servo-ventilation-for-central-sleep-apnoea-in-heart-failure-serve-hf-on-treatment-analysis
#8
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
#9
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
#10
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...
October 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28777366/-complex-sleep-apnea-syndrome
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
Ana Pais, Luiz Menezes Falcão
No abstract text is available yet for this article.
April 25, 2017: American Journal of Therapeutics
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