Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study
Background: The optimal criteria for patient selection in the context of adaptive servo-ventilation (ASV) therapy remain a subject of ongoing investigation. We postulate that baseline plasma volume, assessable through several straightforward clinical parameters, might be correlated with a more prono...
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| Format: | Article |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/674 |
| _version_ | 1797318580402913280 |
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| author | Yu Nomoto Teruhiko Imamura Koichiro Kinugawa |
| author_facet | Yu Nomoto Teruhiko Imamura Koichiro Kinugawa |
| author_sort | Yu Nomoto |
| collection | DOAJ |
| description | Background: The optimal criteria for patient selection in the context of adaptive servo-ventilation (ASV) therapy remain a subject of ongoing investigation. We postulate that baseline plasma volume, assessable through several straightforward clinical parameters, might be correlated with a more pronounced reduction in plasma B-type natriuretic peptide (BNP) levels following mid-term ASV therapy. Methods: We included patients diagnosed with congestive heart failure who had received continuous ASV therapy for a minimum of three months. The primary outcome of interest was the extent of decline in logarithmically transformed plasma BNP levels, defined as a decrease of more than 0.10 during the 3-month ASV treatment period. Results: A total of 66 patients were included in the study. The median age of the cohort was 66 years, with 53 patients (80%) being male. The median plasma volume status at baseline was −16.9%, and patients were categorized into two groups based on this median value. Patients with elevated baseline plasma volume status experienced a statistically significant reduction in plasma BNP levels (<i>p</i> = 0.016), whereas those with lower plasma volume exhibited no significant change in BNP levels (<i>p</i> = 0.23). A higher baseline plasma volume status was independently associated with a significant reduction in plasma BNP levels, with an adjusted odds ratio of 1.036 (95% confidence interval: 1.01–1.07, <i>p</i> = 0.032). Conclusions: The presence of systemic congestion at baseline, quantified by the estimated plasma volume status, may serve as a crucial determinant of the efficacy of ASV therapy, leading to improvements in plasma BNP levels among patients suffering from congestive heart failure. |
| first_indexed | 2024-03-08T03:54:23Z |
| format | Article |
| id | doaj.art-2a8c7132540f4b6f9a919e0c06f71555 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:54:23Z |
| publishDate | 2024-01-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2a8c7132540f4b6f9a919e0c06f715552024-02-09T15:15:32ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113367410.3390/jcm13030674Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational StudyYu Nomoto0Teruhiko Imamura1Koichiro Kinugawa2Second Department of Internal Medicine, Toyama University, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, Toyama University, 2630 Sugitani, Toyama 930-0194, JapanSecond Department of Internal Medicine, Toyama University, 2630 Sugitani, Toyama 930-0194, JapanBackground: The optimal criteria for patient selection in the context of adaptive servo-ventilation (ASV) therapy remain a subject of ongoing investigation. We postulate that baseline plasma volume, assessable through several straightforward clinical parameters, might be correlated with a more pronounced reduction in plasma B-type natriuretic peptide (BNP) levels following mid-term ASV therapy. Methods: We included patients diagnosed with congestive heart failure who had received continuous ASV therapy for a minimum of three months. The primary outcome of interest was the extent of decline in logarithmically transformed plasma BNP levels, defined as a decrease of more than 0.10 during the 3-month ASV treatment period. Results: A total of 66 patients were included in the study. The median age of the cohort was 66 years, with 53 patients (80%) being male. The median plasma volume status at baseline was −16.9%, and patients were categorized into two groups based on this median value. Patients with elevated baseline plasma volume status experienced a statistically significant reduction in plasma BNP levels (<i>p</i> = 0.016), whereas those with lower plasma volume exhibited no significant change in BNP levels (<i>p</i> = 0.23). A higher baseline plasma volume status was independently associated with a significant reduction in plasma BNP levels, with an adjusted odds ratio of 1.036 (95% confidence interval: 1.01–1.07, <i>p</i> = 0.032). Conclusions: The presence of systemic congestion at baseline, quantified by the estimated plasma volume status, may serve as a crucial determinant of the efficacy of ASV therapy, leading to improvements in plasma BNP levels among patients suffering from congestive heart failure.https://www.mdpi.com/2077-0383/13/3/674non-invasive positive pressure supporthemodynamicsheart failure |
| spellingShingle | Yu Nomoto Teruhiko Imamura Koichiro Kinugawa Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study Journal of Clinical Medicine non-invasive positive pressure support hemodynamics heart failure |
| title | Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study |
| title_full | Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study |
| title_fullStr | Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study |
| title_full_unstemmed | Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study |
| title_short | Systemic Congestion as a Determinant of Efficacy in Adaptive Servo-Ventilation Therapy: A Retrospective Observational Study |
| title_sort | systemic congestion as a determinant of efficacy in adaptive servo ventilation therapy a retrospective observational study |
| topic | non-invasive positive pressure support hemodynamics heart failure |
| url | https://www.mdpi.com/2077-0383/13/3/674 |
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