FACE: Prospective multicenter cohort addressing chronic heart failure patients with central sleep disorder breathing indicated for adaptive servo ventilation: patient baseline characteristics - 25/09/20
Résumé |
Introduction |
Adaptive servo-ventilation (ASV) is a non-invasive ventilation mode for suppressing CSA-CSR. FACE is an observational prospective multicentre cohort study designed to assess the effects of adding ASV (PaceWave™, AutosetCS™; ResMed) to standard care on morbidity and mortality in symptomatic chronic HF patients who have CSA or co-existing central and obstructive sleep-disordered breathing (SDB).
Objective |
To collect real life clinical data and long-term follow-up of all CHF patients grade of severity (reduced (HFrEF), mid-range (HFmrEF) or preserved ejection fraction (HFpEF)) with SDB requesting ASV.
Methods |
Medical history, medications, clinical presentation, sleep study, cardiac function and quality of life were assessed at inclusion. Patients are followed up to 2 years. Inclusion data are presented in median with interquartile range or in % of the sample.
Results |
509 CHF pts were included, 72 [64; 79] year old, men (88%) and with a BMI of 28 [25; 32] kg/m2. Patients were HFrEF, HFmrEF and HFpEF, in 31, 20, and 50% respectively and 27% had a cardiac implant. Current or former tobacco and alcohol users were 46 and 14% respectively. Main comorbidities were hypertension (72%), diabetes (37%), COPD (12%), atrial fibrillation (40%). ASV indications were predominant CSA (69%), emergent CSA (6.4%) and coexistent OSA-CSA not controlled on CPAP (25%). Although, SDB was severe with a mean AHI per hour of 41 [31; 55] and a sleep time with SpO2<90% (T90) of 33min [5;101] patients were not sleepy with an ESS of 7 [4; 11]. HF symptoms were highly present with a Minnesota Living With Heart Failure Questionnaire (MLHFQ) score of 29 [16; 48] and pts distribution of 19, 43, 33 and 5% in NYHA class I, II, III and IV respectively.
Conclusion |
SDB were widespread distributed in a heterogeneous population of CHF patients with different etiologies, comorbidities and HF severity classes. A cluster analysis has been conducted to identify different phenogroups.
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Vol 12 - N° 2-4
P. 248 - octobre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.