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Canadian Journal of Cardiology

Increased Mortality Associated With Adaptive Servo-Ventilation Therapy in Heart Failure Patients With Central Sleep Apnea in the Halted SERVE-HF Trial

  • Haran Yogasundaram
    Affiliations
    Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
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  • Gavin Y. Oudit
    Correspondence
    Corresponding author: Dr Gavin Y. Oudit, Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta T6G 2S2, Canada. Tel.: +1-780-407-8569; fax: +1-780-407-6452.
    Affiliations
    Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
    Search for articles by this author
      Heart failure (HF) is a complex syndrome that is increasing in prevalence on a worldwide basis and carries a high morbidity and mortality resulting in a huge economic burden. Although HF is initially driven by primary cardiac dysfunction, the syndrome culminates into a multisystem process involving the central nervous system, lungs, kidneys, and skeletal muscles. Targeting the involvement of noncardiac pathways remains an important approach to minimize the progression of HF and to improve clinical outcomes. As highlighted in the July 2015 issue of the Canadian Journal of Cardiology, sleep disordered breathing is strongly associated with HF, and treatment of central sleep apnea (CSA) and obstructive sleep apnea plays an important role in the management of these patients.
      • Lyons O.D.
      • Bradley T.D.
      Heart failure and sleep apnea.
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      Linked Article

      • Reply to Letter From Floras et al.—Central Sleep Apnea: Risk Factor or Pathogenic Process in Patients With Heart Failure
        Canadian Journal of CardiologyVol. 32Issue 3
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          We thank Floras et al.1 for their interest in our News and Commentary on the use of adaptive servo-ventilation (ASV) therapy in symptomatic patients with heart failure and reduced ejection fraction.2 As clearly delineated in our News and Commentary, the safety advisory was issued based on the findings of increased mortality in patients receiving ASV in the Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure (SERVE-HF) trial. The actual results of the trial were presented at the 2015 European Society of Cardiology Congress and recently published in the New England Journal of Medicine.
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      • Adaptive Servo Ventilation for Central Sleep Apnea: More Data, Please
        Canadian Journal of CardiologyVol. 32Issue 3
        • Preview
          The SERVE-HF trial (Treatment of Predominant Central Sleep Apnoea by Adaptive Servo Ventilation in Patients With Heart Failure) commentary by Yogasundaram and Oudit contains a factual error and several misconceptions that could discourage others from initiating or completing other trials such as the ADVENT-HF trial (A Multi-Centre Randomized Study to Assess the Effects of Adaptive Servo Ventilation on Survival and Frequency of Cardiovascular Hospital Admissions in Patients with Heart Failure and Sleep Apnea) of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea (CSA) and obstructive sleep apnea (OSA) in heart failure (HF) that involve different devices.
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