Abstract
Adaptive servo-ventilation (ASV) has been attracting attention as a novel respiratory support therapy for heart failure (HF). However, the acute hemodynamic effects have not been compared between ASV and continuous positive airway pressure (CPAP) in HF patients. We studied 12 consecutive patients with stable chronic HF. Hemodynamic measurement was performed by right heart catheterization before and after CPAP 5 cmH2O, CPAP 10 cmH2O, and ASV for 15 minutes each. Heart rate, blood pressure, pulmonary capillary wedge pressure (PCWP), and stroke volume index (SVI) were not changed by any intervention. Right atrial pressure significantly increased after CPAP 10 cmH2O (3.6 ± 3.3 to 6.7 ± 1.6 mmHg, P = 0.005) and ASV (4.1 ± 2.6 to 6.8 ± 1.5 mmHg, P = 0.026). Cardiac index was significantly decreased by CPAP 10 cmH2O (2.3 ± 0.4 to 1.9 ± 0.3 L/minute/m2, P = 0.048), but was not changed by ASV (2.3 ± 0.4 to 2.0 ± 0.3 L/ minute/m2, P = 0.299). There was a significant positive correlation between baseline PCWP and % of baseline SVI by CPAP 10 cmH2O (r = 0.705, P < 0.001) and ASV (r = 0.750, P < 0.001). ASV and CPAP 10 cmH2O had significantly greater slopes of this correlation than CPAP 5 cmH2O, suggesting that patients with higher PCWP had a greater increase in SVI by ASV and CPAP 10 cmH2O. The relationship between baseline PCWP and % of baseline SVI by ASV was shifted upwards compared to CPAP 10 cmH2O. Furthermore, based on the results of a questionnaire, patients accepted CPAP 5 cmH2O and ASV more favorably compared to CPAP 10 cmH2O. ASV had more beneficial effects on acute hemodynamics and acceptance than CPAP in HF patients.
| Original language | English |
|---|---|
| Pages (from-to) | 527-532 |
| Number of pages | 6 |
| Journal | International heart journal |
| Volume | 56 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sep 29 2015 |
| Externally published | Yes |
Fingerprint
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
Cite this
Adaptive servo-ventilation has more favorable acute effects on hemodynamics than continuous positive airway pressure in patients with Heart Failure. / Asakawa, Naoya; Sakakibara, Mamoru; Noguchi, Keiji; Kamiya, Kiwamu; Yamada, Shiro; Yoshitani, Takashi; Ono, Kota; Oba, Koji; Tsutsui, Hiroyuki.
In: International heart journal, Vol. 56, No. 5, 29.09.2015, p. 527-532.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adaptive servo-ventilation has more favorable acute effects on hemodynamics than continuous positive airway pressure in patients with Heart Failure
AU - Asakawa, Naoya
AU - Sakakibara, Mamoru
AU - Noguchi, Keiji
AU - Kamiya, Kiwamu
AU - Yamada, Shiro
AU - Yoshitani, Takashi
AU - Ono, Kota
AU - Oba, Koji
AU - Tsutsui, Hiroyuki
PY - 2015/9/29
Y1 - 2015/9/29
N2 - Adaptive servo-ventilation (ASV) has been attracting attention as a novel respiratory support therapy for heart failure (HF). However, the acute hemodynamic effects have not been compared between ASV and continuous positive airway pressure (CPAP) in HF patients. We studied 12 consecutive patients with stable chronic HF. Hemodynamic measurement was performed by right heart catheterization before and after CPAP 5 cmH2O, CPAP 10 cmH2O, and ASV for 15 minutes each. Heart rate, blood pressure, pulmonary capillary wedge pressure (PCWP), and stroke volume index (SVI) were not changed by any intervention. Right atrial pressure significantly increased after CPAP 10 cmH2O (3.6 ± 3.3 to 6.7 ± 1.6 mmHg, P = 0.005) and ASV (4.1 ± 2.6 to 6.8 ± 1.5 mmHg, P = 0.026). Cardiac index was significantly decreased by CPAP 10 cmH2O (2.3 ± 0.4 to 1.9 ± 0.3 L/minute/m2, P = 0.048), but was not changed by ASV (2.3 ± 0.4 to 2.0 ± 0.3 L/ minute/m2, P = 0.299). There was a significant positive correlation between baseline PCWP and % of baseline SVI by CPAP 10 cmH2O (r = 0.705, P < 0.001) and ASV (r = 0.750, P < 0.001). ASV and CPAP 10 cmH2O had significantly greater slopes of this correlation than CPAP 5 cmH2O, suggesting that patients with higher PCWP had a greater increase in SVI by ASV and CPAP 10 cmH2O. The relationship between baseline PCWP and % of baseline SVI by ASV was shifted upwards compared to CPAP 10 cmH2O. Furthermore, based on the results of a questionnaire, patients accepted CPAP 5 cmH2O and ASV more favorably compared to CPAP 10 cmH2O. ASV had more beneficial effects on acute hemodynamics and acceptance than CPAP in HF patients.
AB - Adaptive servo-ventilation (ASV) has been attracting attention as a novel respiratory support therapy for heart failure (HF). However, the acute hemodynamic effects have not been compared between ASV and continuous positive airway pressure (CPAP) in HF patients. We studied 12 consecutive patients with stable chronic HF. Hemodynamic measurement was performed by right heart catheterization before and after CPAP 5 cmH2O, CPAP 10 cmH2O, and ASV for 15 minutes each. Heart rate, blood pressure, pulmonary capillary wedge pressure (PCWP), and stroke volume index (SVI) were not changed by any intervention. Right atrial pressure significantly increased after CPAP 10 cmH2O (3.6 ± 3.3 to 6.7 ± 1.6 mmHg, P = 0.005) and ASV (4.1 ± 2.6 to 6.8 ± 1.5 mmHg, P = 0.026). Cardiac index was significantly decreased by CPAP 10 cmH2O (2.3 ± 0.4 to 1.9 ± 0.3 L/minute/m2, P = 0.048), but was not changed by ASV (2.3 ± 0.4 to 2.0 ± 0.3 L/ minute/m2, P = 0.299). There was a significant positive correlation between baseline PCWP and % of baseline SVI by CPAP 10 cmH2O (r = 0.705, P < 0.001) and ASV (r = 0.750, P < 0.001). ASV and CPAP 10 cmH2O had significantly greater slopes of this correlation than CPAP 5 cmH2O, suggesting that patients with higher PCWP had a greater increase in SVI by ASV and CPAP 10 cmH2O. The relationship between baseline PCWP and % of baseline SVI by ASV was shifted upwards compared to CPAP 10 cmH2O. Furthermore, based on the results of a questionnaire, patients accepted CPAP 5 cmH2O and ASV more favorably compared to CPAP 10 cmH2O. ASV had more beneficial effects on acute hemodynamics and acceptance than CPAP in HF patients.
UR - http://www.scopus.com/inward/record.url?scp=84942939246&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942939246&partnerID=8YFLogxK
U2 - 10.1536/ihj.15-110
DO - 10.1536/ihj.15-110
M3 - Article
C2 - 26370373
AN - SCOPUS:84942939246
VL - 56
SP - 527
EP - 532
JO - International Heart Journal
JF - International Heart Journal
SN - 1349-2365
IS - 5
ER -