TY - JOUR
T1 - Design of the effect of adaptive servo-ventilation on survival and cardiovascular hospital admissions in patients with heart failure and sleep apnoea
T2 - the ADVENT-HF trial
AU - for the ADVENT-HF Investigators
AU - Lyons, Owen D.
AU - Floras, John S.
AU - Logan, Alexander G.
AU - Beanlands, Robert
AU - Cantolla, Joaquin Durán
AU - Fitzpatrick, Michael
AU - Fleetham, John
AU - John Kimoff, R.
AU - Leung, Richard S.T.
AU - Lorenzi Filho, Geraldo
AU - Mayer, Pierre
AU - Mielniczuk, Lisa
AU - Morrison, Debra L.
AU - Ryan, Clodagh M.
AU - Series, Frederic
AU - Tomlinson, George A.
AU - Woo, Anna
AU - Arzt, Michael
AU - Parthasarathy, Sairam
AU - Redolfi, Stefania
AU - Kasai, Takatoshi
AU - Parati, Gianfranco
AU - Delgado, Diego H.
AU - Bradley, T. Douglas
N1 - Publisher Copyright:
© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Introduction: Both types of sleep-disordered breathing (SDB), obstructive and central sleep apnoea (OSA and CSA, respectively), are common in patients with heart failure and reduced ejection fraction (HFrEF). In such patients, SDB is associated with increased cardiovascular morbidity and mortality but it remains uncertain whether treating SDB by adaptive servo-ventilation (ASV) in such patients reduces morbidity and mortality. Aim: ADVENT-HF is designed to assess the effects of treating SDB with ASV on morbidity and mortality in patients with HFrEF. Methods: ADVENT-HF is a multicentre, multinational, randomized, parallel-group, open-label trial with blinded assessment of endpoints of standard medical therapy for HFrEF alone vs. with the addition of ASV in patients with HFrEF and SDB. Patients with a history of HFrEF undergo echocardiography and polysomnography. Those with a left ventricular ejection fraction ≤45% and SDB (apnoea–hypopnoea index ≥15) are eligible. SDB is stratified into OSA with ≥50% of events obstructive or CSA with >50% of events central. Those with OSA must not have excessive daytime sleepiness (Epworth score of ≤10). Patients are then randomized to receive or not receive ASV. The primary outcome is the composite of all-cause mortality, cardiovascular hospital admissions, new-onset atrial fibrillation requiring anti-coagulation but not hospitalization, and delivery of an appropriate discharge from an implantable cardioverter-defibrillator not resulting in hospitalization during a maximum follow-up time of 5 years. Conclusion: The ADVENT-HF trial will help to determine whether treating SDB by ASV in patients with HFrEF improves morbidity and mortality.
AB - Introduction: Both types of sleep-disordered breathing (SDB), obstructive and central sleep apnoea (OSA and CSA, respectively), are common in patients with heart failure and reduced ejection fraction (HFrEF). In such patients, SDB is associated with increased cardiovascular morbidity and mortality but it remains uncertain whether treating SDB by adaptive servo-ventilation (ASV) in such patients reduces morbidity and mortality. Aim: ADVENT-HF is designed to assess the effects of treating SDB with ASV on morbidity and mortality in patients with HFrEF. Methods: ADVENT-HF is a multicentre, multinational, randomized, parallel-group, open-label trial with blinded assessment of endpoints of standard medical therapy for HFrEF alone vs. with the addition of ASV in patients with HFrEF and SDB. Patients with a history of HFrEF undergo echocardiography and polysomnography. Those with a left ventricular ejection fraction ≤45% and SDB (apnoea–hypopnoea index ≥15) are eligible. SDB is stratified into OSA with ≥50% of events obstructive or CSA with >50% of events central. Those with OSA must not have excessive daytime sleepiness (Epworth score of ≤10). Patients are then randomized to receive or not receive ASV. The primary outcome is the composite of all-cause mortality, cardiovascular hospital admissions, new-onset atrial fibrillation requiring anti-coagulation but not hospitalization, and delivery of an appropriate discharge from an implantable cardioverter-defibrillator not resulting in hospitalization during a maximum follow-up time of 5 years. Conclusion: The ADVENT-HF trial will help to determine whether treating SDB by ASV in patients with HFrEF improves morbidity and mortality.
KW - Adaptive servo-ventilation
KW - Cardiovascular hospital admissions
KW - Central sleep apnoea
KW - Heart failure
KW - Mortality
KW - Obstructive sleep apnoea
KW - Sleep-disordered breathing
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U2 - 10.1002/ejhf.790
DO - 10.1002/ejhf.790
M3 - Article
C2 - 28371141
AN - SCOPUS:85016507724
SN - 1388-9842
VL - 19
SP - 579
EP - 587
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 4
ER -