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Acute Hemodynamic Effects of Adaptive Servo-Ventilation in Patients With Heart Failure

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Title: Acute Hemodynamic Effects of Adaptive Servo-Ventilation in Patients With Heart Failure
Authors: Yamada, Shiro Browse this author
Sakakibara, Mamoru Browse this author →KAKEN DB
Yokota, Takashi Browse this author →KAKEN DB
Kamiya, Kiwamu Browse this author →KAKEN DB
Asakawa, Naoya Browse this author
Iwano, Hiroyuki Browse this author →KAKEN DB
Yamada, Satoshi Browse this author →KAKEN DB
Oba, Koji Browse this author
Tsutsui, Hiroyuki Browse this author →KAKEN DB
Keywords: Adaptive servo-ventilation
Heart failure
Hemodynamics
Mitral regurgitation
Remodeling
Issue Date: 2013
Publisher: The Japanese Circulation Society
Journal Title: Circulation Journal
Volume: 77
Issue: 5
Start Page: 1214
End Page: 1220
Publisher DOI: 10.1253/circj.CJ-12-1088
Abstract: Background: Adaptive servo-ventilation (ASV) improves cardiac function in patients with heart failure (HF). We compared the hemodynamics of control and HF patients, and identified the predictors for acute effects of ASV in HF. Methods and Results: We performed baseline echocardiographic measurements and hemodynamic measurements at baseline and after 15min of ASV during cardiac catheterization in 11 control and 34 HF patients. Heart rate and blood pressure did not change after ASV in either the control or HF group. Stroke volume index (SVI) decreased from 49.3±7.6 to 41.3±7.6ml/m2 in controls (P<0.0001) but did not change in the HF patients (from 34.8±11.5 to 32.8±8.9ml/m2, P=0.148). In the univariate analysis, pulmonary capillary wedge pressure (PCWP), mitral regurgitation (MR)/left atrial (LA) area, E/A, E/e’, and the sphericity index defined by the ratio between the short-axis and long-axis dimensions of the left ventricle significantly correlated with % change of SVI from baseline during ASV. PCWP and MR/LA area were independent predictors by multivariate analysis. Moreover, responders (15 of 34 HF patients; 44%) categorized by an increase in SVI showed significantly higher PCWP, MR, and sphericity index. Conclusions: Left ventricular structure and MR, as well as PCWP, could predict acute favorable effects on hemodynamics by ASV therapy in HF patients.  (Circ J 2013; 77: 1214–1220)
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/76973
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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