Source: Annual Congress 2008 - Outcome of adaptive servo ventilation in sleep apnoea
Disease area: Sleep and breathing disorders

Abstract

Background:
Adaptive servoventilation (ASV) can normalize Cheyne-Stokes-Respiration and central sleep apnea (CSR-CSA) in patients with heart failure. We hypothesized that ASV by normalizing AHI has a benefitial effect on neurohumoral activation and induces a decrease of elevated BNP levels.
Material and methods:
Prospective study of ASV (1.4.2004 to 31.10.2006) in patients with heart failure regardless of ejection fraction, a BNP (Biosite®) > 100 pg/ml and CSR-CSA, separated in subgroups with and without OSA. Follow-up with full night polysomnography and control of BNP after 6 weeks. Enrollment of patients who used ASV > 4 h/night.
Results:
13 male patients (age 69.0 ± 7.7 years, BMI 33.,3 ± 5.4 kg/m², pCO₂ 35.8 ± 3.3 mmHg, AHI was 47.2 ± 15.4/h). 6 patients had CSR-CSA and obstructive sleep apnea (CSR-CSA+OSA), 7 patients had CSR-CSA without OSA. After 6 weeks of ASV BNP decreased from 414.3 ± 185.3 pg/ml to 267.8 ± 153.6 pg/ml (p = 0.0019). AHI (2.5 ± 3.9/h – p < 0.001) and arousal-index (17.1 ± 9.9/h – p < 0.01) were normalized. BNP reduction was significantly higher (p = 0.0018) in patients with CSR-CSA+OSA. In the CSR-CSA subgroup without OSA BNP reduction did not reach significance (p = 0.16). The reduction in responders was significant (p = 0.006), but smaller than in the CSR-CSA+OSA group.
Conclusion:
By normalizing AHI in patients with heart failure and CSR-CSA Adaptive servoventilation significantly reduces elevated BNP levels. OSA has a significant influence on neurohumoral activation.

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Citations should be made in the following way:
M. Westhoff, P. Litterst (Hemer, Germany). Influence of adaptive servoventilation (ASV) on BNP in patients with Cheyne-Stokes respiration and central sleep apnea (CSR-CSA), with and without obstructive sleep apnea. Eur Respir J 2008; 32: Suppl. 52, 4216

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