Distúrbios respiratórios do sono na insuficiência cardíaca: o estado da arte depois do estudo SERVE‐HF

Translated title of the contribution: Sleep-disordered breathing in heart failure: The state of the art after the SERVE-HF trial

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Heart failure (HF) is one of the most prevalent conditions worldwide and despite therapeutic advances, its prognosis remains poor. Among the multiple comorbidities in HF, sleep-disordered breathing (SDB) is frequent and worsens the prognosis. Preliminary observational studies suggested that treatment of SDB could modify the prognosis of HF, and the issue has gained importance in recent years. The diagnosis of SDB is expensive, slow and suboptimal, and there is thus a need for screening devices that are easier to use and validated in this population. The first-line treatment involves optimization of medical therapy for heart failure. Continuous positive airway pressure (CPAP) is used in patients who mainly suffer from obstructive sleep apnea. In patients with predominantly central sleep apnea, CPAP is not sufficient and adaptive servo-ventilation (ASV), despite promising results in observational studies, showed no benefit in patients with symptomatic HF and reduced ejection fraction in the SERVE-HF randomized trial; on the contrary, there was unexpectedly increased mortality in the ASV group compared to controls, and so ASV is contraindicated in these patients, calling into question the definition and pathogenesis of SDB and risk stratification in these patients. There are many gaps in the evidence, and so further research is needed to better understand this issue: definitions, simple screening methods, and whether and how to treat SDB in patients with HF.

Translated title of the contributionSleep-disordered breathing in heart failure: The state of the art after the SERVE-HF trial
Original languagePortuguese
Pages (from-to)859-867
Number of pages8
JournalRevista Portuguesa de Cardiologia
Volume36
Issue number11
Early online date18 Nov 2017
DOIs
Publication statusPublished - Nov 2017

Keywords

  • Adaptive servo‐ventilation
  • Distúrbios respiratórios do sono
  • Heart failure
  • Insuficiência cardíaca
  • Non‐invasive ventilation
  • Prognosis
  • Prognóstico
  • Servo‐ventilação adaptativa
  • Sleep‐disordered breathing
  • Tratamento
  • Treatment
  • Ventilação não invasiva

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