Related Experiment Video
Updated: May 29, 2026
08:35
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Adaptive servo-ventilation improves renal function in patients with heart failure
Takashi Koyama1, Hiroyuki Watanabe, Shigenori Terada
1Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Hondoh 1-1-1, Akita 010-8543, Japan.
Respiratory Medicine
|September 30, 2011
Summary
Adaptive servo-ventilation (ASV) therapy improved kidney function in heart failure (HF) patients with sleep-disordered breathing (SDB). ASV therapy enhanced estimated glomerular filtration rate (eGFR) by supporting hemodynamics and reducing inflammation.
Area of Science:
- Cardiology
- Nephrology
- Sleep Medicine
Background:
- Heart failure (HF) patients with sleep-disordered breathing (SDB) experience worsening chronic kidney disease (CKD).
- Adaptive servo-ventilation (ASV) therapy improves cardiac function in HF patients by providing hemodynamic support and preventing hypoxic stress.
Purpose of the Study:
- To investigate the effect of ASV therapy on renal function in HF patients who have SDB.
Main Methods:
- A cohort of 59 HF patients with moderate-to-severe SDB were analyzed.
- Patients were divided into ASV-treated (n=27) and non-ASV-treated (n=16) groups.
- Renal function (eGFR), cardiac function (echocardiography), and inflammatory markers were assessed before and 12 months after ASV initiation.
Main Results:
- The ASV-treated group showed significant improvement in eGFR, while the non-ASV-treated group did not.
- Increased eGFR correlated positively with improved left ventricular ejection fraction (r = 0.488, p = 0.001).
- Decreased high-sensitivity C-reactive protein levels correlated with eGFR improvement (r = -0.416, p = 0.006).
Conclusions:
- ASV therapy can ameliorate renal dysfunction in HF patients with SDB through hemodynamic support.
- ASV therapy may also improve renal function by reducing inflammation associated with SDB.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:22Heart Failure Drugs: Diuretics
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:29Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...