Long-term effect of adaptive servo ventilation on patients with chronic heart failure and sleep-disordered breathing: Meta analysis / 解放军医学杂志

ABSTRACT

Objective To evaluate the long-tem effect of adaptive servo ventilation (ASV) on patients with chronic heart failure (CHF) and sleep-disordered breathing (SDB). Methods The controlled clinical articles were searched included in PubMed, Cochrane, EMBASE and CBM, CJFD, WangFang Database from Jan. 1970 to Dec. 2015. Included standard left ventricular ejection fraction (LVEF) ≤55%, apnea hypopnea index (AHI) ≥15/h, follow up period over 4 weeks. After quality assessment (modified Jadad score) and data extraction by two independent reviewers, mete analysis was performed with RevMan 5.3 software. Results Thirteen studies were recruited including 442 cases being followed over 4 weeks [ASV group 233 cases and control group 216 cases (corssover design 7)]. Compared to control group, LVEF increased [weighted mean difference (WMD)=3.72, 95%CI 1.80-5.64, PP<0.01] and AHI decreased significantly (WMD=–18.63, 95%CI –26.19-–11.08), the distance walked in 6 minutes increased (WMD=28.72, 95%CI 2.26-55.18, P=0.03) and plasma N terminal brain natriuretic peptide precursor (NT-pro BNP) decreased significantly (WMD=–744.03, 95%CI –1262.45-–225.62, P<0.05) in ASV group. Conclusion Over 4 weeks ASV may improve LVEF and AHI, increase 6-min walking distance and decrease NT-pro BNP in patients with CHF and SDB.