Beneficial effects of adaptive servo-ventilation therapy on albuminuria in patients with heart failure

• Published in: Journal of cardiology Vol. 65; no. 5; pp. 412 - 417
• Main Authors: Tamura, Yoshikazu, MD, Koyama, Takashi, MD, Watanabe, Hiroyuki, MD, Hosoya, Tomoki, MD, Ito, Hiroshi, MD, FJCC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2015
• Subjects: Adaptive servo-ventilation; Aged; Albuminuria - etiology; Albuminuria - therapy; Albuminuria - urine; C-Reactive Protein - urine; Cardiovascular; Creatinine - urine; Female; Heart failure; Heart Failure - complications; Humans; Inflammation; Male; Microalbuminuria; Middle Aged; Norepinephrine - urine; Positive-Pressure Respiration - methods; Sympathetic nerve activity; Time Factors; Treatment Outcome; Heart failure; Inflammation; Adaptive servo-ventilation; Microalbuminuria; Sympathetic nerve activity
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2014.07.008

Abstract Background Short-duration adaptive servo-ventilation (ASV) therapy can be effective for heart failure (HF) patients. Albuminuria is recognized as a prognostic marker for HF. We investigated whether short-duration and short-term ASV therapy reduced albuminuria in HF patients. Methods and results Twenty-one consecutive HF patients were divided into two groups: those who tolerated ASV therapy (ASV group, n = 14) and those who did not (non-ASV group, n = 7). ASV therapy was administered to enrolled patients for 1 week for 2 h per day (1 h in the morning and 1 h in the afternoon). The urinary albumin to creatinine ratio (UACR), urinary 24 h norepinephrine (NE) excretion, high-sensitivity C-reactive protein (hs-CRP), and plasma brain natriuretic peptide (BNP) levels were measured before and 1 week after ASV therapy. In the ASV group, but not the non-ASV group, the UACR significantly decreased, together with a decrease in urinary NE and hs-CRP levels. There were significant correlations between the changes in UACR and hs-CRP and between the changes in urinary NE and hs-CRP. Multiple linear regression analyses indicated that ASV use was the strongest predictor of decreased UACR. Conclusion Albuminuria, urinary NE, and hs-CRP levels reduced in HF patients who could receive short-duration and short-term ASV therapy. Anti-inflammatory effects of ASV therapy may partly mediate the reduction of albuminuria.