Abstract 12515: Short- and Long-term Prognosis of Adaptive Servo Ventilation Therapy for Patients With Heart Failure With Preserved Ejection Fraction

Introduction: In Japan, Adaptive Servo Ventilation (ASV) is usually used for heart failure patients with sleep disordered breathing. However, SERVE-HF trial showed that ASV therapy could not reduce mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF) in addition to optimized medical care in spite our data conflicting findings concerning these results. However, there is no data whether ASV therapy shows effectiveness and safety for patients with heart failure with preserved ejection fraction (HFpEF). Hypothesis: Our aim is to estimate short- and long-term prognosis of ASV therapy for patients with HFpEF compared with standard optical medical therapy. Methods: After medical therapy was optimized, a total of 157 consecutive HFpEF patients were divided into 2 groups. Fifty-six patients were tried to initiate ASV therapy (Group A), and 101 patients were categorized into optimal medical therapy (Group M). We estimate the short- (1-year) and long-term (average observational period: 1140±778 days) prognosis of ASV therapy for patients with HFpEF. Results: Short-term prognosis showed that ASV was equally effective and safe therapy for patients with HFpEF (Survival rate: Group A: 94.6%, Group M: 93.07%, p=0.699) (Figure 1A). On the other hands, long-term prognosis showed that ASV therapy had a tendency to fall into high fatal cardiovascular event rate (Group A: 19.6%, Group M: 9.9%, p=0.086) (Figure 1B). Especially, Group A with high central sleep apnea {central apnea index (CAI) ≧10/h} showed significant higher fatal cardiovascular event rate (CAI ≧10/h: 35.7%, CAI <10/h: 14.3%, Group M: 9.9%, p=0.029) (Figure 1C). Conclusions: Our results showed that short-term ASV therapy was effective and safe for patients with HFpEF compared with optimal medical therapy. On the other hands, long-term ASV therapy had limited effectiveness against HFpEF.