open access

Vol 69, No 12 (2011)
Original articles
Published online: 2011-12-15
Submitted: 2012-12-28
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Resolution of exercise oscillatory ventilation with adaptive servoventilation in patients with chronic heart failure and Cheyne−Stokes respiration: preliminary study

Anna Kazimierczak, Krystian Krzyżanowski, Robert Wierzbowski, Robert Ryczek, Paweł Smurzyński, Dariusz Michałkiewicz, Zbigniew Orski, Grzegorz Gielerak
Kardiol Pol 2011;69(12):1266-1271.

open access

Vol 69, No 12 (2011)
Original articles
Published online: 2011-12-15
Submitted: 2012-12-28

Abstract

Background: Exercise oscillatory ventilation (EOV) is a common pattern of breathing in heart failure (HF) patients, and indicates a poor prognosis.
Aim: To investigate the effects of adaptive servoventilation (ASV) on ventilatory response during exercise.
Methods: We studied 39 HF patients with left ventricular ejection fraction (LVEF) £ 45. Cardiorespiratory polygraphy, cardiopulmonary exercise testing (CPET), echocardiography, and measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration were performed. Twenty patients with Cheyne-Stokes respiration and apnoea–hypopnoea index (AHI) ≥ 15/h were identified. Of these, 11 patients were successfully titrated on ASV and continued therapy. In the third month of ASV treatment, polygraphy, CPET, echocardiography, and measurement of NT-proBNP concentration were performed again.
Results: The EOV was detected at baseline in 12 (31%) HF patients, including eight (67%) who underwent ASV. The EOV was associated with significantly lower LVEF, peak oxygen uptake (VO2), and ventilatory anaerobic threshold (VAT), and a significantly higher left ventricular diastolic diameter (LVDD), slope of ventilatory equivalent for carbon dioxide (VE/VCO2), AHI, central AHI and NT-proBNP concentration. In seven patients with EOV, reversal of EOV in the third month of ASV therapy was observed; only in one patient did EOV persist (p = 0.0156).
Conclusions: The EOV can be reversed with ASV therapy. The EOV in association with central sleep apnoea and Cheyne- -Stokes respiration (CSA/CSR) is prevalent in HF patients and correlates with severity of the disease.
Kardiol Pol 2011; 69, 12: 1266–1271

Abstract

Background: Exercise oscillatory ventilation (EOV) is a common pattern of breathing in heart failure (HF) patients, and indicates a poor prognosis.
Aim: To investigate the effects of adaptive servoventilation (ASV) on ventilatory response during exercise.
Methods: We studied 39 HF patients with left ventricular ejection fraction (LVEF) £ 45. Cardiorespiratory polygraphy, cardiopulmonary exercise testing (CPET), echocardiography, and measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration were performed. Twenty patients with Cheyne-Stokes respiration and apnoea–hypopnoea index (AHI) ≥ 15/h were identified. Of these, 11 patients were successfully titrated on ASV and continued therapy. In the third month of ASV treatment, polygraphy, CPET, echocardiography, and measurement of NT-proBNP concentration were performed again.
Results: The EOV was detected at baseline in 12 (31%) HF patients, including eight (67%) who underwent ASV. The EOV was associated with significantly lower LVEF, peak oxygen uptake (VO2), and ventilatory anaerobic threshold (VAT), and a significantly higher left ventricular diastolic diameter (LVDD), slope of ventilatory equivalent for carbon dioxide (VE/VCO2), AHI, central AHI and NT-proBNP concentration. In seven patients with EOV, reversal of EOV in the third month of ASV therapy was observed; only in one patient did EOV persist (p = 0.0156).
Conclusions: The EOV can be reversed with ASV therapy. The EOV in association with central sleep apnoea and Cheyne- -Stokes respiration (CSA/CSR) is prevalent in HF patients and correlates with severity of the disease.
Kardiol Pol 2011; 69, 12: 1266–1271
Get Citation

Keywords

exercise oscillatory ventilation; sleep-disordered breathing

About this article
Title

Resolution of exercise oscillatory ventilation with adaptive servoventilation in patients with chronic heart failure and Cheyne−Stokes respiration: preliminary study

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 69, No 12 (2011)

Pages

1266-1271

Published online

2011-12-15

Bibliographic record

Kardiol Pol 2011;69(12):1266-1271.

Keywords

exercise oscillatory ventilation
sleep-disordered breathing

Authors

Anna Kazimierczak
Krystian Krzyżanowski
Robert Wierzbowski
Robert Ryczek
Paweł Smurzyński
Dariusz Michałkiewicz
Zbigniew Orski
Grzegorz Gielerak

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