caa a22 4500 606220674 CHVBK 20210128101125.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00380-014-0558-8 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0558-8 Adaptive servo-ventilation therapy using an innovative ventilator for patients with chronic heart failure: a real-world, multicenter, retrospective, observational study (SAVIOR-R) [Elektronische Daten] [Shin-ichi Momomura, Yoshihiko Seino, Yasuki Kihara, Hitoshi Adachi, Yoshio Yasumura, Hiroyuki Yokoyama] Adaptive servo-ventilation (ASV) therapy using an innovative ventilator—originally developed to treat sleep-disordered breathing (SDB)—is a novel modality of noninvasive positive pressure ventilation and is gaining acceptance among Japanese cardiologists in expectation of its applicability to treat patients with chronic heart failure (CHF) based on its acute beneficial hemodynamic effects. We conducted a multicenter, retrospective, real-world observational study in 115 Japanese patients with CHF, who had undergone home ASV therapy for the first time from January through December 2009, to examine their profile and the effects on their symptoms and hemodynamics. Medical records were used to investigate New York Heart Association (NYHA) class, echocardiographic parameters including left ventricular ejection fraction (LVEF), cardiothoracic ratio (CTR), brain natriuretic peptide (BNP), and other variables. Most of the patients were categorized to NYHA classes II (44.4%) and III (40.7%). SDB severity was not determined in 44 patients, and SDB was not detected or was mild in 27 patients. In at least 71 patients (61.7%), therefore, ASV therapy was not applied for the treatment of SDB. CHF was more severe, i.e., greater NYHA class, lower LVEF, and higher CTR, in 87 ASV-continued patients (75.7%) than in 28 ASV-discontinued patients (24.3%). However, SDB severity was not related to continuity of ASV. The combined proportion of NYHA classes III and IV (P=0.012) and LVEF (P=0.009) improved significantly after ASV therapy. CTR and BNP did not improve significantly after ASV therapy but showed significant beneficial changes in their time-course analysis (P<0.05, respectively). Improvements in LVEF and NYHA class after ASV therapy were not influenced by SDB severity at onset. The present study suggests that ASV therapy would improve the symptoms and hemodynamics of CHF patients, regardless of SDB severity. A randomized clinical study to verify these effects is warranted. The Author(s), 2014 Adaptive servo-ventilation nationallicence Chronic heart failure nationallicence Noninvasive positive pressure ventilation nationallicence Cardiac function nationallicence Sleep-disordered breathing nationallicence Momomura Shin-ichi Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, 330-8503, Saitama, Japan aut Seino Yoshihiko Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan aut Kihara Yasuki Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan aut Adachi Hitoshi Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan aut Yasumura Yoshio Cardiovascular Division, Osaka National Hospital, Osaka, Japan aut Yokoyama Hiroyuki Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan aut Heart and Vessels Springer Japan 30/6(2015-11-01), 805-817 0910-8327 30:6<805 2015 30 380 https://doi.org/10.1007/s00380-014-0558-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0558-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Momomura Shin-ichi Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-Cho, Omiya-Ku, 330-8503, Saitama, Japan aut NATIONALLICENCE 700 1- Seino Yoshihiko Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan aut NATIONALLICENCE 700 1- Kihara Yasuki Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan aut NATIONALLICENCE 700 1- Adachi Hitoshi Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan aut NATIONALLICENCE 700 1- Yasumura Yoshio Cardiovascular Division, Osaka National Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Yokoyama Hiroyuki Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/6(2015-11-01), 805-817 0910-8327 30:6<805 2015 30 380