SERVE HF Trial Summary: Adaptive sero-ventilation for CSA in HF

serve hf trial

2015 SERVE-HF TRIAL M Adaptive servo-ventilation for central sleep apnea in systolic heart failure parallel, randomized controlled trial Objective: To assess the effectiveness of adaptive servo-ventilation Damong subjects with heart failure with reduced ejection fraction and central sleep apnea 1315 patients Inclusion criteria: Patients ≥ 22 years (1) with chronic heart failure due to LVEF <45% (2) NYHA class II-IV symptoms (3) apnea-hypopnea index > 15 events per hour (majority central events) 99 VS Adaptive servo-ventilation (n=666) Optimal medical management (n=659) 54.1 PRIMARY OUTCOME Composite of all-cause mortality, lifesaving CV intervention, or hospitalization for HF % HR 1.13; 95% CI, 0.97 to 1.31; P=0.10 SECONDARY OUTCOMES 50.8 34.8 All-cause mortality % 29.3 HR 1.28; 95% CI, 1.06 to 1.55; P=0.01 Cardiovascular mortality % 29.9 HR 1.34; 95% CI, 1.09 to 1.65; P=0.006 24.0 Conclusion: Adaptive servo-ventilation had no significant effect on the primary end point in patients who had heart failure with reduced ejection fraction & predominantly central sleep apnea, but all-cause & CV mortality were both increased with this therapy. MR Cowie et al. NEJM 2015; 373:1095-1105