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Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing

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Abstract

Sleep-disordered breathing (SDB) deteriorates the prognosis of patients with chronic heart failure (CHF). Adaptive servo ventilation (ASV) is a new therapeutic modality to treat SDB including Cheyne–Stokes respiration associated with central sleep apnea. Renal function plays critical roles in the progression of CHF and is a strong predictor of clinical outcomes. Cystatin C is a marker of renal function, and more sensitive than serum creatinine. The purpose of the present study was to examine whether ASV is effective for cardiac overload and renal dysfunction in CHF patients with SDB. Fifty patients with CHF and SDB (mean left ventricular ejection fraction 34.0 %, estimated glomerular filtration rate (eGFR) 62.8 ml/min/1.73 cm2) were examined. We performed polysomnography for two consecutive days (baseline and on ASV), and measured levels of serum N terminal-pro B-type natriuretic peptide (NT-pro BNP), cystatin C, and estimated glomerular filtration rate based on cystatin C (eGFR Cyst C). ASV significantly improved the apnea hypopnea index, central apnea index, obstructive apnea index, arousal index, mean SPO2, and lowest SPO2 compared to baseline. ASV decreased NT-pro BNP (1,109.0 (2,173.2) to 912.8 (1,576.7) pg/ml, p < 0.05), cystatin C (1.391 ± 0.550–1.348 ± 0.489 mg/l, p < 0.05), and increased eGFR Cyst C (61.9 ± 30.8–65.7 ± 33.8 ml/min/1.73 cm2, p < 0.01). ASV improved SDB, reduced cardiac overload, and ameliorated renal function in CHF patients with SDB. ASV has short-term beneficial effects on not only SDB but also cardio-renal function. ASV might be a promising useful tool for CHF as an important non-pharmacotherapy with cardio-renal protection.

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Acknowledgments

The authors acknowledge the efforts of Dr. Aya Goto (Department of Public Health, Fukushima Medical University) for advice of medical statistics. This study was supported in part by a grant-in-aid for Scientific Research (No. 21790737) from Japan Society for the Promotion of Science.

Conflict of interest

Akiomi Yoshihisa and Satoshi Suzuki: affiliated with endowed department, Fukuda Denshi Co., Ltd.

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Authors and Affiliations

  1. Department of Advanced Cardiac Therapeutics, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Akiomi Yoshihisa & Satoshi Suzuki

  2. Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Akiomi Yoshihisa, Satoshi Suzuki, Takashi Owada, Shoji Iwaya, Hiroyuki Yamauchi, Makiko Miyata, Takayoshi Yamaki, Koichi Sugimoto, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh & Yasuchika Takeishi

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  1. Akiomi Yoshihisa
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Correspondence to Akiomi Yoshihisa.

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Yoshihisa, A., Suzuki, S., Owada, T. et al. Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing. Heart Vessels 28, 728–734 (2013). https://doi.org/10.1007/s00380-012-0303-0

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