Cor Vasa 2013, 55(5):e411-e418 | DOI: 10.1016/j.crvasa.2013.06.005

Advances in the management of sleep-disordered breathing in heart failure

Pavel Matuška^a,*, Tomáš Kára^a, Pavel Homolka^b, Miloš Bělehrad^a

^a International Clinical Research Center - Kardiovaskulární spánkové výzkumné centrum, Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

^b International Clinical Research Center - Klinika tělovýchovného lékařství a rehabilitace, Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

Obstructive (OSA) and central sleep apnea (CSA) are very common in patients with congestive heart failure (CHF). This is clearly a risk factor for worsening the prognosis of patients. Treatment of sleep apnea in these patients may stop disease progression. Modern therapy, primarily central sleep apnea, is provided by adaptive servoventilation (ASV). Short-term randomized trials have demonstrated that treatment with ASV increased ejection fraction (EF), reduces sympathetic activity and blood pressure. Unfortunately, there is not enough data on whether there are effects on mortality and morbidity. Studies of this issue, such as SERVE-HF and ADVENT-HF, are currently in progress and results are expected. There are other forms of therapy of OSA like CPAP, oxygen, theophylline, acetazolamide, cardiac resynchronisation therapy and transplantation. In patients with a predominance of OSA, in addition to previous methods, there are other recommended forms of therapy as appropriate weight loss, orthodontic appliances and surgical treatment.

Keywords: Adaptive servoventilation; Cheyne-Stokes breathing; Heart failure; Sleep apnea

Received: April 24, 2013; Accepted: June 25, 2013; Published: October 1, 2013  Show citation