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The efficacy and safety of adaptive servo-ventilation therapy for heart failure with preserved ejection fraction

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Abstract

It is unclear whether adaptive servo-ventilation (ASV) therapy for heart failure with preserved ejection fraction (HFpEF) is effective. The aim of this study was to investigate the details of ASV use, and to evaluate the effectiveness and safety of ASV in real-world HFpEF patients. We retrospectively enrolled 36 HFpEF patients at nine cardiovascular centers who initiated ASV therapy during hospitalization or on outpatient basis and were able to continue using it at home from 2012 to 2017 and survived for at least one year thereafter. The number of hospitalizations for heart failure (HF) during the 12 months before and 12 months after introduction of ASV at home was compared. The median number of HF hospitalizations for each patient was significantly reduced from 1 [interquartile range: 1–2] in the 12 months before introduction of ASV to 0 [0–0] in the 12 months after introduction of ASV (p < 0.001). In subgroup analysis, reduction in heart failure hospitalization was significantly greater in female patients, patients with a body mass index < 25, and those with moderate or severe tricuspid valve regurgitation. In patients with HFpEF, the number of HF hospitalizations was significantly decreased after the introduction of ASV. HFpEF patients with female sex, BMI < 25, or moderate to severe tricuspid valve regurgitation are potential candidates who might benefit from ASV therapy.

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Data availability

All data relevant to the study are included in the article or uploaded as supplementary information. Data sharing is not applicable in this study due to the restrictions of institutional review boards.

References

  1. Koyama T, Watanabe H, Igarashi G, Terada S, Makabe S, Ito H (2011) Short-term prognosis of adaptive servo-ventilation therapy in patients with heart failure. Circ J 75(3):710–712

    Article  PubMed  Google Scholar 

  2. Yoshida M, Ando SI, Kodama K, Ebihara K, Tanaka K, Hayashi A, Taguchi E, Kadokami T, Nakao K, Sakamoto T (2017) Adaptive servo-ventilation therapy reduces hospitalization rate in patients with severe heart failure. Int J Cardiol 238:173–176

    Article  PubMed  Google Scholar 

  3. Hiasa G, Okayama H, Hosokawa S, Kosaki T, Kawamura G, Shigematsu T, Takahashi T, Kawada Y, Yamada T, Matsuoka H, Saito M, Sumimoto T, Kazatani Y (2018) Beneficial effects of adaptive servo-ventilation therapy on readmission and medical costs in patients with chronic heart failure. Heart Vessels 33(8):859–865

    Article  PubMed  Google Scholar 

  4. Asakawa N, Sakakibara M, Noguchi K, Kamiya K, Yamada S, Yoshitani T, Ono K, Oba K, Tsutsui H (2015) Adaptive servo-ventilation has more favorable acute effects on hemodynamics than continuous positive airway pressure in patients with heart failure. Int Heart J 56(5):527–532

    Article  CAS  PubMed  Google Scholar 

  5. Momomura S, Seino Y, Kihara Y, Adachi H, Yasumura Y, Yokoyama H, Wada H, Ise T, Tanaka K, SAVIOR-C investigators (2015) Adaptive servo-ventilation therapy for patients with chronic heart failure in a confirmatory, multicenter, randomized, controlled study. Circ J 79(5):981–990

    Article  PubMed  Google Scholar 

  6. Teschler H, Döhring J, Wang YM, Berthon-Jones M (2001) Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure. Am J Respir Crit Care Med 164(4):614–619

    Article  CAS  PubMed  Google Scholar 

  7. Koyama T, Watanabe H, Tamura Y, Oguma Y, Kosaka T, Ito H (2013) Adaptive servo-ventilation therapy improves cardiac sympathetic nerve activity in patients with heart failure. Eur J Heart Fail 15(8):902–909

    Article  PubMed  Google Scholar 

  8. Takama N, Kurabayashi M (2011) Effectiveness of adaptive servo-ventilation for treating heart failure regardless of the severity of sleep-disordered breathing. Circ J 75(5):1164–1169

    Article  PubMed  Google Scholar 

  9. Cowie MR, Woehrle H, Wegscheider K, Angermann C, d’Ortho MP, Erdmann E, Levy P, Simonds AK, Somers VK, Zannad F, Teschler H (2015) Adaptive servo-ventilation for central sleep apnea in systolic heart failure. N Engl J Med 373(12):1095–1105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Momomura S, Seino Y, Kihara Y, Adachi H, Yasumura Y, Yokoyama H (2015) Adaptive servo-ventilation therapy using an innovative ventilator for patients with chronic heart failure: a real-world, multicenter, retrospective, observational study (SAVIOR-R). Heart Vessels 30(6):805–817

    Article  PubMed  Google Scholar 

  11. Oldenburg O, Bartsch S, Bitter T, Schmalgemeier H, Fischbach T, Westerheide N, Horstkotte D (2012) Hypotensive effects of positive airway pressure ventilation in heart failure patients with sleep-disordered breathing. Sleep Breath 16(3):753–757

    Article  PubMed  Google Scholar 

  12. O’Connor CM, Whellan DJ, Fiuzat M, Punjabi NM, Tasissa G, Anstrom KJ, Benjafield AV, Woehrle H, Blase AB, Lindenfeld J, Oldenburg O (2017) Cardiovascular outcomes with minute ventilation-targeted adaptive servo-ventilation therapy in heart failure: the CAT-HF trial. J Am Coll Cardiol 69(12):1577–1587

    Article  PubMed  Google Scholar 

  13. Yoshihisa A, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y (2013) Impact of adaptive servo-ventilation on cardiovascular function and prognosis in heart failure patients with preserved left ventricular ejection fraction and sleep-disordered breathing. Eur J Heart Fail 15(5):543–550

    Article  CAS  PubMed  Google Scholar 

  14. D’Elia E, Ferrero P, Vittori C, Iacovoni A, Grosu A, Gori M, Duino V, PerliniS SM (2019) Beneficial effects of adaptive servo-ventilation on natriuretic peptides and diastolic function in acute heart failure patients with preserved ejection fraction and sleep-disordered breathing. Sleep Breath 23(1):287–291

    Article  CAS  PubMed  Google Scholar 

  15. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, ESCScientific Document Group (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599–3726

    Article  CAS  PubMed  Google Scholar 

  16. Birner C, Series F, Lewis K, Benjamin A, Wunderlich S, Escourrou P, Zeman F, Luigart R, Pfeifer M, Arzt M (2014) Effects of auto-servo ventilation on patients with sleep-disordered breathing, stable systolic heart failure and concomitant diastolic dysfunction: subanalysis of a randomized controlled trial. Respiration 87(1):54–62

    Article  PubMed  Google Scholar 

  17. Olsson KM, Frank A, Fuge J, Welte T, Hoeper MM, Bitter T (2015) Acute hemodynamic effects of adaptive servoventilation in patients with pre-capillary and post-capillary pulmonary hypertension. Respir Res 16:137

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hall AB, Ziadi MC, Leech JA, Chen SY, Burwash IG, Renaud J, deKemp RA, Haddad H, Mielniczuk LM, Yoshinaga K, Guo A, Chen L, Walter O, Garrard L, DaSilva JN, Floras JS, Beanlands RS (2014) Effects of short-term continuous positive airway pressure on myocardial sympathetic nerve function and energetics in patients with heart failure and obstructive sleep apnea: a randomized study. Circulation 130(11):892–901

    Article  PubMed  Google Scholar 

  19. Gorter TM, Hoendermis ES, van Veldhuisen DJ, Voors AA, Lam CS, Geelhoed B, Willems TP, van Melle JP (2016) Right ventricular dysfunction in heart failure with preserved ejection fraction: a systematic review and meta-analysis. Eur J Heart Fail 18(12):1472–1487

    Article  PubMed  Google Scholar 

  20. Oeun B, Hikoso S, Nakatani D, Mizuno H, Suna S, Kitamura T, Okada K, Dohi T, Sotomi Y, Kojima T, Kida H, Sunaga A, Sato T, Takeda Y, Kurakami H, Yamada T, Tamaki S, Abe H, Nakagawa Y, Higuchi Y, Fuji H, Mano T, Uematsu M, Yasumura Y, Yamada T, Sakata Y, OCVC-Heart Failure Investigators (2021) Prognostic Impact of Echocardiographic Diastolic Dysfunction on Outcomes in Patients With Heart Failure With Preserved Ejection Fraction- Insights From the PURSUIT-HFpEF Registry. Circ J 86(1):23–33

    Article  PubMed  Google Scholar 

  21. Nakagawa A, Yasumura Y, Yoshida C, Okumura T, Tateishi J, Yoshida J, Abe H, Tamaki S, Yano M, Hayashi T, Nakagawa Y, Yamada T, Nakatani D, Hikoso S, Sakata Y (2020) Prognostic importance of right ventricular-vascular uncoupling in acute decompensated heart failure with preserved ejection fraction. Circ Cardiovasc Imaging 13(11):e011430

    Article  PubMed  Google Scholar 

  22. Murakami T, Nakamura N, Natsumeda M, Matsumoto S, Sakai K, Ohno Y, Nakazawa G, Shinozaki N, Ikari Y (2022) Impact of tolvaptan on improvement of tricuspid regurgitation and right ventricular dimension in patients with right-sided heart failure. Heart Vessels 37(7):1153–1161

    Article  PubMed  Google Scholar 

  23. Sotomi Y, Hikoso S, Nakatani D, Mizuno H, Okada K, Dohi T, Kitamura T, Sunaga A, Kida H, Oeun B, Sato T, Komukai S, Tamaki S, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Yasumura Y, Yamada T, Sakata Y, PURSUIT‐HFpEF Investigators (2021) Sex differences in heart failure with preserved ejection fraction. J Am Heart Assoc 10(5):e018574

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Matsuhiro Y, Nishino M, Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yano M, Egami Y, Shutta R, Tanouchi J, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Nakagawa A, Nakagawa Y, Sotomi Y, Nakatani D, Hikoso S, Sakata Y, Osaka CardioVascular Conference (OCVC) -HeartFailure Investigators (2021) Underweight is associated with poor prognosis in heart failure with preserved ejection fraction. Int Heart J 62(5):1042–1051

    Article  PubMed  Google Scholar 

  25. Itoh H, Kaneko H, Kiriyama H, Kamon T, Fujiu K, Morita K, Yotsumoto H, Michihata N, Jo T, Takeda N, Morita H, Yasunaga H, Komuro I (2021) Reverse J-shaped relationship between body mass index and in-hospital mortality of patients hospitalized for heart failure in Japan. Heart Vessels 36(3):383–392

    Article  PubMed  Google Scholar 

  26. Su VY, Liu CJ, Wang HK, Wu LA, Chang SC, Perng DW, Su WJ, Chen YM, Lin EY, Chen TJ, Chou KT (2014) Sleep apnea and risk of pneumonia: a nationwide population-based study. CMAJ 186(6):415–421

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sanner BM, Fluerenbrock N, Kleiber-Imbeck A, Mueller JB, Zidek W (2001) Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome. Respiration 68(5):483–487

    Article  CAS  PubMed  Google Scholar 

  28. Takama N, Kurabayashi M (2014) Safety and efficacy of adaptive servo-ventilation in patients with severe systolic heart failure. J Cardiol 63(4):302–307

    Article  PubMed  Google Scholar 

  29. Gay PC (2009) Complications of noninvasive ventilation in acute care. Respir Care 54(2):246–257

    PubMed  Google Scholar 

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Acknowledgements

We thank Nagisa Yoshioka, Satomi Kishimoto, Kyoko Tatsumi, and Kentaro Tachibana for their excellent assistance with data collection.

Funding

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan

    Hirota Kida, Shungo Hikoso, Yuki Matsuoka, Taiki Sato, Akihiro Sunaga, Bolrathanak Oeun, Takayuki Kojima, Yohei Sotomi, Tomoharu Dohi, Katsuki Okada, Shinichiro Suna, Hiroya Mizuno, Daisaku Nakatani & Yasushi Sakata

  2. Department of Clinical Engineering, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan

    Tatsuhiko Uruno & Shigetaka Kusumoto

  3. Department of Clinical Engineering, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-Ku, Sakai, 591-8025, Japan

    Keiji Yamamoto

  4. Department of Clinical Engineering, Japan Community Healthcare Organization Osaka Hospital, 4-2-78 Fukushima, Osaka, 553-0003, Japan

    Hirofumi Matsumoto

  5. Department of Clinical Engineering, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Osaka, 530-0001, Japan

    Akimasa Abe

  6. Department of Clinical Engineering, Osaka Police Hospital, 10-31 Kitayamacho, Osaka, 545-0035, Japan

    Daizo Kato

  7. Department of Clinical Engineering, Osaka International Cancer Institute, 3-1-69 Otemae, Osaka, 541-8567, Japan

    Eiji Uza

  8. Department of Clinical Engineering, Otemae Hospital, 1-5-34 Otemae, Osaka, 540-0008, Japan

    Takashi Doi

  9. Department of Clinical Engineering, Rinku General Medical Center, 2-23 Rinkuourai-Kita, Izumisano, 598-0048, Japan

    Tadashi Iwamoto

  10. Department of Medical Innovation, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Japan

    Hiroyuki Kurakami & Tomomi Yamada

  11. Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan

    Tetsuhisa Kitamura

  12. Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan

    Katsuki Okada

Authors
  1. Hirota Kida
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  2. Shungo Hikoso
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  6. Hirofumi Matsumoto
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  9. Eiji Uza
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  13. Tomomi Yamada
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  14. Tetsuhisa Kitamura
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  15. Yuki Matsuoka
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  16. Taiki Sato
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  17. Akihiro Sunaga
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  18. Bolrathanak Oeun
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  19. Takayuki Kojima
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  20. Yohei Sotomi
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  21. Tomoharu Dohi
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  23. Shinichiro Suna
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  25. Daisaku Nakatani
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  26. Yasushi Sakata
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Corresponding author

Correspondence to Shungo Hikoso.

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This study was approved by the Ethics Committee of Osaka University and was conducted in accordance with the Helsinki Declaration. Reference number: 18372.

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Kida, H., Hikoso, S., Uruno, T. et al. The efficacy and safety of adaptive servo-ventilation therapy for heart failure with preserved ejection fraction. Heart Vessels 38, 1404–1413 (2023). https://doi.org/10.1007/s00380-023-02297-y

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