Use of adaptive servo ventilation therapy as treatment of sleep-disordered breathing and heart failure: a systematic review and meta-analysis

Purpose Adaptive servoventilation (ASV) has been reported to show improvement in patients with sleep-disordered breathing (SDB) and heart failure (HF); however, its role as a second-line or adjunctive treatment is not clear. We conducted a systematic review and meta-analysis of new existing data inc...

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Bibliographic Details
Published in:Sleep & breathing 2020-03, Vol.24 (1), p.49-63
Main Authors: Hernandez, Adrian V., Jeon, Anne, Denegri-Galvan, Jack, Ortega-Loayza, Fernando, Felix-Moscoso, Monica, Pasupuleti, Vinay, Kaw, Roop
Format: Article
Language:English
Subjects:
Aged
Apnea
Blood pressure
Brain natriuretic peptide
Clinical trials
Cohort Studies
Comorbidity
Congestive heart failure
Dentistry
Female
Heart failure
Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Meta-analysis
Middle Aged
Neurology
Otorhinolaryngology
Pediatrics
Pneumology/Respiratory System
Positive-Pressure Respiration - methods
Randomized Controlled Trials as Topic
Respiration
Sleep
Sleep Apnea Syndromes - diagnosis
Sleep Apnea Syndromes - physiopathology
Sleep Apnea Syndromes - therapy
Sleep Breathing Physiology and Disorders • Review
Sleep disorders
Stroke Volume - physiology
Systematic review
Treatment Outcome
Ventilation
Ventricle
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Summary:Purpose Adaptive servoventilation (ASV) has been reported to show improvement in patients with sleep-disordered breathing (SDB) and heart failure (HF); however, its role as a second-line or adjunctive treatment is not clear. We conducted a systematic review and meta-analysis of new existing data including cardiac mechanistic factor, geometry, and cardiac biomarkers. Methods We systematically searched for randomized controlled trials (RCTs) and cohort studies that assessed the efficacy or effectiveness of ASV compared to conventional treatments for SDB and HF in five research databases from their inception to November 2018. Random-effects meta-analyses using the inverse variance method and stratified by study design were performed. Results We included 15 RCTs ( n  = 859) and 5 cohorts ( n  = 162) that met our inclusion criteria. ASV significantly improved left ventricular ejection fraction (LVEF) in cohorts (MD 6.96%, 95% CI 2.58, 11.34, p  = 0.002), but not in RCTs. Also, the ASV group had significantly lower apnea-hypopnea index (AHI) in both cohorts (MD − 26.02, 95% CI − 36.94, − 15.10, p  
ISSN:1520-9512
1522-1709
DOI:10.1007/s11325-019-01882-8