Real-World Data of Adaptive Servo-Ventilation Therapy for Patients with Heart Failure with Reduced Ejection Fraction: Three-Year Follow-Up Data Based on Comparison with Standard Medical Therapy

Background: Sleep-disordered breathing (SDB) is a cause of heart failure. Adaptive servo-ventilation (ASV) is one of the treatments for SDB. Recently, ASV has been applied to the treatment of patients with heart failure and SDB. The aim of this study was to estimate whether ASV therapy is effective and safe for patients with heart failure with reduced ejection fraction (HFrEF) compared with standard medical therapy in the real world, using three-year follow-up data. Methods: The patients with HFrEF (n=186) were treated with standard medical therapy plus ASV therapy (ASV group; n=57) or standard medical therapy alone (control group; n=129). We followed up the patients for 3 years. Results: The ASV group had significantly lower baseline left ventricular ejection fraction than the control group (27.9 ± 8.6% vs. 34.1 ± 8.8%; P<0.0001). Baseline brain natriuretic peptide (BNP) did not differ significantly between the groups. On follow-up, the changes in BNP level indicated that the ASV group showed significantly better improvement than the control group. There was no significant difference between the groups in the rate of fatal cardiovascular events (P=0.190, log-rank test). Conclusion: ASV therapy was effective for the treatment of HFrEF, and the rate of fatal cardiovascular events were not higher in the ASV group in the real world.