IMPACT OF ADAPTIVE SERVO-VENTILATION IN HEART FAILURE PATIENTS

Background: Sleep related breathing disorders (SRBD) as obstructive apnea, central apnea and Cheyne-Stokes respiration (CSR) can be seen in patients with chronic heart failure. SRBD can influence prognosis of heart failure. Objective: To reveal sleep related breathing disorders in patients with heart failure and to display the effects of adaptive servo-ventilation (ASV) as a new therapy modality. Materials and Methods: In this prospective study, 32 patients with heart failure were included. One night polysomnography (PSG) was done. Results: According to the results of PSG, SRBD ratio was 96,7%. Continuous positive airway pressure (CPAP) and ASV titrations were offered to all patients with apnea-hypopnea index (AHI) > 5. Demographics and clinical properties, symptoms, PSG findings, presence of Cheyne-Stokes respiration (CSR), echocardiography results were recorded. Before and after ASV titration, pulmonary function tests, walking tests were performed, concentrations of transferrin and pro-BNP were determined. In the groups according to the AHI, severe OSAS in 18 of 30 patients, 4 moderate OSAS, 5 mild OSAS and 2 central sleep apnea (CSA). PSG and CPAP, ASV titrations done in 7 male and 1 female patients that obstructive apnea, central apnea, AHI, arousal and SpO2 min values had significant improvements (p=0,001 p=0,016 p=0,001 p=0,015 p=0,008 respectively). We determined all CSRs were eliminated with ASV. After ASV titration pro-BNP, walking distance and FVC values changed significantly (p=0,036 p=0,018 p=0,018 respectively). Conclusion: In the result, we determined cheyne-stokes respiration and central apneas persisted with CPAP but eliminated with one-night ASV application. ASV also decreased pro-BNP and increased FVC and walking distance values significantly.