Heart failure & cardiomyopathies
Hypoxaemic Burden in Heart Failure Patients Receiving Adaptive Servo-Ventilation
Authors' conclusion
ASV effectively suppresses the sleep apnoea-related component of hypoxaemic burden in HFrEF patients. A significant hypoxaemic burden not directly attributable to sleep apnoea but related to the severity of heart failure remains and may adversely affect cardiovascular long-term outcomes.
Study context
- Population
- Stable heart failure with reduced ejection fraction (HFrEF) patients with LVEF ≤ 40
- Participants
- 56 patients
- Comparison
- Adaptive servo-ventilation (ASV) plus optimal medical management vs optimal medical management alone
- ASVn = 27
- Controln = 29reference
- Primary endpoint
- Hypoxaemic burden: time at <90% oxygen saturation (T90) on overnight polysomnography
- Follow-up
- 12 weeks
Primary result
As reported in the abstract
T90
| Group | Value | Baseline |
|---|---|---|
| ASV | mean 20.5 (SD 33.0) min | 50.1 ± 95.8 min |
| Control | mean 65.4 (SD 89.6) min | 59.6 ± 88 |
Value
ASVmean 20.5 (SD 33.0) min
Controlmean 65.4 (SD 89.6) min
Baseline
ASV50.1 ± 95.8 min
Control59.6 ± 88
- ASV vs Control: P = 0.009 — T90 shortened by nearly 60% with ASV
Further findings
Apnoea-related component (T90desaturation) · 12 weeks
P = 0.008
Baseline ASV 37.7 ± 54.5 · Control 37.7 ± 54.5
Determinants of T90 components (adjusted multivariable regression)
| β (95% CI) | P value | |
|---|---|---|
| T90desaturationAssociation with FEV1/FVC ratio | 0.336 (0.080–0.593) | P = 0.011 |
| T90non-specificAssociation with LVEF | −0.345 (−0.616 to −0.073) | P = 0.014 |
- Non-specific T90 component (T90non-specific) during ASV
- 19.6 · mean · SD 31.8 · min
Original publication
Hypoxaemic Burden in Heart Failure Patients Receiving Adaptive Servo-Ventilation. ESC Heart Fail. Published 4 October 2023. doi:10.
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