Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Circ J. 2012;76(11):2606-13. doi: 10.1253/circj.cj-12-0328. Epub 2012 Jul 31.
The aim of this study was to investigate whether short-duration adaptive servo-ventilation (ASV) therapy improves cardiac function in heart failure (HF) patients.
Consecutive HF patients (n=86) were divided into 3 groups: group A, ASV for a mean of ≥4 h; group B, ASV for ≥1 to <4 h per day; and group C, no ASV or ASV <1 h. The frequency of ASV use did not significantly differ between groups A (79.3±19.2%) and B (70.9±17.4%). After 6 months, a significant increase in left ventricular ejection fraction (LVEF), significant decrease in plasma brain natriuretic peptide (BNP) and decrease in LV end-diastolic volume (LVEDV) were observed in groups A (LVEF, 5.0±8.1%; BNP, -24.9±33.7%; LVEDV, -6.2±10.1%) and B (LVEF, 3.5±5.5%; BNP, -16.5±24.6%; LVEDV, -5.1±8.2%) as compared with group C (LVEF, -1.5±6.0%, P=0.004, P=0.017; BNP, 2.8±10.2%, P=0.002, P=0.017; LVEDV, 0.8±9.1%, P=0.031, P=0.043). Significant correlation was seen between the total ASV time and changes of LVEF (r=0.369, P=0.002), BNP (r=-0.445, P<0.001), and LVEDV (r=-0.374, P=0.001). Admission rate was lower in groups A (4.1%) and B (7.1%) than in group C (25%, log-rank test; P=0.042, P=0.045). Multivariate analysis showed that the frequency of ASV use was a strong parameter for the improvement of LVEF (coefficient=0.284, standard error=0.035, P=0.019).
Even a short-duration of ASV therapy may improve cardiac function in HF patients.
本研究旨在探讨短时间适应性伺服通气（ASV）治疗是否能改善心力衰竭（HF）患者的心功能。
连续 86 例 HF 患者分为 3 组：A 组，ASV 治疗时间平均≥4 h；B 组，ASV 治疗时间≥1 至<4 h/d；C 组，无 ASV 或 ASV<1 h。A 组（79.3±19.2%）和 B 组（70.9±17.4%）的 ASV 使用频率无显著差异。6 个月后，A 组（LVEF 增加 5.0±8.1%，BNP 降低-24.9±33.7%，LVEDV 降低-6.2±10.1%）和 B 组（LVEF 增加 3.5±5.5%，BNP 降低-16.5±24.6%，LVEDV 降低-5.1±8.2%）较 C 组（LVEF 增加 1.5±6.0%，P=0.004，P=0.017；BNP 增加 2.8±10.2%，P=0.002，P=0.017；LVEDV 增加 0.8±9.1%，P=0.031，P=0.043）左心室射血分数（LVEF）、血浆脑钠肽（BNP）和左心室舒张末期容积（LVEDV）明显改善。ASV 总时间与 LVEF（r=0.369，P=0.002）、BNP（r=-0.445，P<0.001）和 LVEDV（r=-0.374，P=0.001）的变化呈显著相关性。A 组（4.1%）和 B 组（7.1%）的入院率低于 C 组（25%，log-rank 检验；P=0.042，P=0.045）。多变量分析显示，ASV 使用频率是 LVEF 改善的一个强参数（系数=0.284，标准误差=0.035，P=0.019）。
即使是短时间的 ASV 治疗也可能改善 HF 患者的心功能。
