Table 4.
Randomised controlled (and crossover) trials of nocturnal respiratory support in patients with CSR-CSA associated with CHF
Trial | Patient characteristics | Intervention | Duration of treatment | No of patents | Cardiovascular outcomes | ||
CHF cause | NYHA class | Baseline LVEF (%) | |||||
Naughton et al57 | ICM, DCM | 2.5 | 18.3 | CPAP | 1 month | 18 | 6.5% increase in LVEF, reduced nocturnal urine and daytime serum noradrenaline |
Naughton et al58 | ICM, DCM | 2.5 | 21.2 | CPAP | 3 months | 29 | 7.7% increase in LVEF, reduced fatigue and dyspnoea, increased emotional well being and disease mastery (CHFQ) |
Granton et al59 | ICM, DCM | 2.4 | 24 | CPAP | 3 months | 17 | 8.6% increase in LVEF, reduced dyspnoea and fatigue (CHFQ) |
Sin et al60 | ICM, DCM | NA | CPAP | 3 months | 66 | 8% increase in LVEF, 81% relative risk reduction in mortality and transplantation rate | |
Teschler et al61 | ICM, DCM | 2.9 | Fractional shortening 0.19 | APSSV, Bi-V, CPAP, supplemental oxygen | 4 nights (crossover trial) | 14 | APSSV reduced AHI and arousal index more than did CPAP, bilevel ventilation or oxygen supplementation; change in LVEF not measured |
Pepperell et al62 | ICM, DCM | 2.7 | 36.5 | APSSV | 1 month | 30 | Reduced serum BNP, urinary metadrenaline, and daytime somnolence; change in LVEF not measured |
Kohnlein et al63 | ICM, DCM | 2.8 | 23.8 | Bi-V/CPAP | 1 month (crossover trial) | 18 | Bilevel ventilation and CPAP equally improved circulation time; improved sleep quality, reduced daytime fatigue (SF-36) and NYHA class; change in LVEF not measured |
APSSV, adaptive pressure support servoventilation; Bi-V, bilevel non-invasive ventilation; BNP, brain natriuretic peptide; NA, not available; SF-36, short form 36 questionnaire.