Author + information
- Noriaki Takama,
- Syuntaro Tamura,
- Kuniko Masuda,
- Makoto Murata,
- Kosaku Goto,
- Yoshiaki Ohyama,
- Ryuichi Funada,
- Norimichi Koitabashi,
- Masashi Arai and
- Masahiko Kurabayashi
Adaptive servo ventilation (ASV) has been successfully used for treating heart failure (HF) in patients with central sleep apnea. However, it remains what factors are the most important predictors of fatal cardiovascular events after ASV therapy. The Integrated Area of Desaturation (IAD) index is new measurement for assessing the severity of sleep apnea, which is obtained by integrating nocturnal desaturation area.
An observational cohort study was conducted in 94 patients (mean age: 70 ± 11 years) diagnosed with HF (NYHA Class II-IV) and accepted initiation of ASV therapy. The patients were classified into 2 groups based on incidence of fatal cardiovascular events including death from progressive of HF, cardioembolic stroke, and fatal cardiac arrhythmias. Nineteen patients were classified into the fatal cardiovascular events group. The association between ASV therapy and predictors of fatal cardiovascular events was verified by a Logistic regression analysis.
Before ASV therapy, no significant differences were observed between the 2 groups with respect to gender, body mass index, drug therapy, history of coronary risk factors, and left ventricular ejection fraction. Average age was significant older in fatal cardiovascular events group than in survival group (fatal cardiovascular events group, 75 ± 7 years; survival group, 69 ± 11 years; p = 0.02). Brain natriuretic peptide was significantly higher in fatal cardiovascular events group than in survival group (fatal cardiovascular events group, 812 ± 570 pg/ml; survival group, 474 ± 568 pg/ml; p = 0.02). The IAD index was significantly higher in fatal cardiovascular events group than in survival group (fatal cardiovascular events group, 77.7 ± 54.9 %sec/min; survival group, 47.7 ± 42.6 %sec/min; p = 0.02). According to the Logistic regression analysis that included IAD index, the odds ratio (95% confidence interval) of fatal cardiovascular events was 4.1 (1.23-15.6) (p = 0.03) based on the results of multivariate analysis.
Our results suggest that IAD index is major predictor of fatal cardiovascular events in patients with HF after ASV therapy.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure: Therapeutic Insights
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1306-281
- 2013 American College of Cardiology Foundation