Effects of Adaptive Servoventilation in Patients With Systolic Heart Failure and Sleep-Disordered Breathing
Effects of Adaptive Servoventilation in Patients With Systolic Heart Failure and Sleep-Disordered Breathing
Prospective, follow-up registry of heart failure patients with or without sleep-disordered
 breathing (SDB). To test the hypothesis that treatment of nocturnal central sleep apnea with
 Cheyne-Stokes respiration by adaptive servoventilation (ASV) improves symptoms, cardiac
 performance and event-free survival.
The study is intended to investigate therapeutic effects of adaptive servoventilation in
 patients with sleep-disordered breathing and chronic heart failure. These effects include
 short-/long-term effects on

 -  symptoms and quality of life

 -  physical and cardiac performance (6min walking test, cardiopulmonary exercise testing)

 -  echocardiographic parameters

 -  arrhythmias

 -  NT-proBNP

 -  Respiratory stability (blood gases, rebreathing test, VE/VCO2-slope in cardiopulmonary
 exercise testing)

 -  Compliance with ASV therapy

 -  Event free survival (death, heart transplantation, assist device implantation)

 All of these data are also obtained in patients who basically meet the inclusion criteria but
 in whom sleep-disordered breathing was excluded by means of cardiorespiratory polygraphy or
 polysomnography and in patients with sleep-disordered breathing who do not undergo adaptive
 servoventilation for various reasons.
Inclusion Criteria:

 -  Stable heart failure NYHA ≥ II

 -  EF ≤ 45%

 -  without sleep-disordered breathing (apnea-hypopnea-index <5/h) and those with moderate
 to severe central sleep apnea (apnea-hypopnea index ≥ 15/h) with or without adaptive
 servoventilation therapy

 Exclusion Criteria:

 -  Cardiac resynchronization or pacemaker implantation within the last 6 months

 -  Significant COPD with an forced expiratory one-second capacity relative to vital
 capacity (FEV1/VC)< 70% (GOLD III)

 -  Respiratory insufficiency requiring long-term oxygen therapy

 -  Daytime hypercapnia at rest (pCO2 > 45 mmHg)

 -  Current ventilation therapy

 -  Cardiac surgery, PCI, myocardial infarction, unstable angina, TIA or stroke within 12
 weeks prior to randomization

 -  Acute myocarditis within 6 months prior to randomization

 -  Pregnancy