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Current Treatment Options in Cardiovascular Medicine
Erschienen in: Current Treatment Options in Cardiovascular Medicine 4/2018

01.04.2018 | Heart Failure (W Tang, Section Editor)

Sleep Apnea in Heart Failure

verfasst von: MuChun Tsai, MD, Rami Khayat, MD

Erschienen in: Current Treatment Options in Cardiovascular Medicine | Ausgabe 4/2018

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Abstract

Purpose of review

In this review, we discuss the current treatment options for sleep-disordered breathing (SDB) in patients with heart failure (HF). We address the role of positive airway pressure (PAP) devices and other emerging therapies. The review includes discussion of recent trials that reported negative consequences for the PAP devices in patients with heart failure.

Recent findings

Optimal guideline-directed medical therapies of HF and PAP devices have been the mainstay treatments for HF patients with SDB. Recently, randomized controlled trials (RCTs) evaluated the effect of PAP on clinical outcomes in patients with cardiovascular (CV) disease and heart failure and found no benefit in decreasing fatal and non-fatal CV events. The Sleep Apnea Cardiovascular Endpoints (SAVE) trial evaluated continuous positive airway pressure (CPAP) ventilation in patients with CV disease and obstructive sleep apnea (OSA) and did not observe any improvement in CV effect. In patients with HF and central sleep apnea (CSA), adaptive servo-ventilation (ASV) was hypothesized to help HF outcomes, but the Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure (SERVE-HF) trial did not show any mortality benefit. Instead, the trial suggested an increase in all-cause and CV mortality in the treatment arm.

Summary

currently, studies have not shown the use of PAP therapy to improve any risks of CV outcomes or death in HF patients with sleep apnea, but some associations with improvements in symptoms from OSA have been observed.
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Metadaten
Titel
Sleep Apnea in Heart Failure
verfasst von
MuChun Tsai, MD
Rami Khayat, MD
Publikationsdatum
01.04.2018
Verlag
Springer US
Erschienen in
Current Treatment Options in Cardiovascular Medicine / Ausgabe 4/2018
Print ISSN: 1092-8464
Elektronische ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-018-0624-0

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