Non-invasive mechanical ventilation for sleep disordered breathing and cardiac function in chronic heart failure. More CPAP or more ASV? That is the question

摘要

Patients with chronic heart failure (CHF) represent a major health problem, especially when sleep disordered breathing (SDB) coexists [1,2]. Non-invasive mechanical ventilation (NIV) can be a useful alternative for treating such SDB in heart failure patients. In general, there are two major ventilation modes such as continuous positive airway pressure (CPAP) mode and adaptive servo ventilation (ASV). Kourouklis SP et al. recently published a study showing that effective treatment of SDB by selecting the appropriate NIV devices (i.e. CPAP for obstructive sleep apnea [OSA] or ASV for central sleep apnea [CSA]) resulted in improvements of the left and right ventricular function in patients with CHF [3]. These results were consistent with previous randomized studies of NIV devices in CHF patients with OSA or CSA [4,5]. The main message of this study could be the importance of effective suppression of SDB by NIV and appropriate selection of NIV device for either OSA or CSA. However, the more important aspect of this study is how to apply CPAP for OSA or ASV for CSA.