The Effects Of Adaptive Servo-ventilation Therapy In Patients With Sleep-disordered Breathing And Heart Failure: A Systematic Review And Meta-analysis

Objective Adaptive Servo-ventilation has demonstrated significantlyimproving sleep-disordered breathing in heart failure, and even improvingheart function, but large randomized trials are lacking. We sought toperform a systematic review and meta-analysis of existing data.Methods A systematic search of the Pubmed， Embase, OVIDdatabase and other Chinese literature database were undertaken in February2014. Publications were independently assessed by two investigators toidentify studies that compared ASV to a control condition in adult patientswith SDB and HF. Mean, variability, and sample size data were extractedindependently for the following outcomes: apnea hypopnea index (AHI),central apnea index (CAI), obstructive apnea index (OAI), arousal index(ArI), left ventricular ejection fraction (LVEF), systolic blood pressure(SBP), diastolic blood pressure (DBP), Heart rate (HR), brain natriureticpeptide (BNP).Results Fourteen studies were identified (N=694). Comparing ASVto control conditions, the mean difference in AHI (-16.63events/h;95%CI, -23.13to-10.13) and LVEF (4.56%;95%CI,1.66%to7.46%) bothsignificantly favored ASV. ASV also improved CAI, OAI, SBP, HR andBNP, but not ArI and DBP, compared with control conditions.Conclusions In patients with HF and SDB, ASV was more effectivethan control conditions in improving SDB and cardiac function.