Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

摘要

Sleep disordered breathing (SDB) and anemia influences the progression of chronic heart failure (CHF). Adaptive servo-ventilation (ASV) is an effective therapeutic device for treatment of CHF, however, the impacts of ASV on CHF patients with or without anemia remain unclear. A total of 139 patients with CHF and SDB were divided into two groups: those treated with ASV ( n = 53) and without ASV ( n = 86). All patients were prospectively followed after discharge with the endpoints of cardiac death or progressive heart failure requiring rehospitalization. There were 65 patients (47%) with anemia among all subjects. The apnea hypopnea index was improved, and plasma BNP and high sensitive C-reactive protein levels were decreased in both groups with and without anemia by ASV therapy. The Kaplan-Meier survival curve demonstrated that the cardiac event-free rate in patients with ASV was significantly higher than in those without ASV in the anemia group ( P = 0.008). However, in the non-anemia group, the cardiac event-free rate was similarly high in patients both with and without ASV ( P = 0.664). Multivariate Cox proportional hazard analysis demonstrated that ASV use was an independent predictor of cardiac events in the anemia group ( P = 0.0308), but not in the non-anemia group. ASV treatment for CHF and SDB has more favorable impacts in patients with anemia than in those without anemia.