Effects of nocturnal oxygen therapy on outcome measures in patients with chronic heart failure and cheyne-stokes respiration

Shigetake Sasayama, Toru Izumi, Yoshihiko Seino, Kenji Ueshima, Hidetsugu Asanoi
Circulation Journal: Official Journal of the Japanese Circulation Society 2006, 70 (1): 1-7

BACKGROUND: The effects of nasal oxygen (O(2)) supply at night using conventional home oxygen therapy (HOT) equipment on quality of life (QOL) and sleep-disordered breathing (SDB) were evaluated in patients with congestive heart failure (CHF). Nasal nocturnal O(2) therapy not only stabilizes SDB but also reduces sympathetic activity, and improves exercise capacity in patients with CHF. However, the effects of oxygen on the cardiac function and QOL of heart failure patients have not been fully elucidated.

METHODS AND RESULTS: Fifty-six patients with CHF (New York Heart Association class II - III, left ventricular ejection fraction (LVEF) <or=45%) and central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR) were randomly assigned to receive either nocturnal O(2) (HOT group, n=25) or usual breathing (control group, n=31) for 12 weeks. Respiration, airflow and arterial oxygen levels were monitored with determination of apnea/hypopnea index (AHI) and oxygen desaturation index (ODI) during sleep. LV function was determined by radionuclide angiography or echocardiography. QOL was assessed by the Specific Activity Scale questionnaire. In the HOT group, nocturnal O(2) resulted in significant improvements in AHI (21.0 +/- 10.8 to 10.0+/-11.6 events/h, mean +/- SD, p<0.001), ODI (19.5 +/- 9.8 to 5.9 +/- 8.7 dips/h, p<0.001) and Specific Activity scale (4.0 +/- 1.2 to 5.0 +/- 1.5 Mets, p<0.001). LVEF also increased from baseline to the end of the study (34.7 +/- 10.4 to 38.2 +/- 13.6%, p=0.022).

CONCLUSIONS: In patients with stable CHF and CSR, HOT at night improves SDB, LV function and QOL, and thus is a valuable nonpharmacological option for the treatment of patients with CHF and CSR-CSA.

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