- Figure 22
Conclusions
FIG. 22: So in conclusion, CanPAP showed that CPAP alleviated CSA and improved cardiovascular function and exercise capacity.[10] The LVEF and 6-min walking distance also both improved (data not shown here), but transplant-free survival was not improved and hospitalizations were not reduced. Therefore, CanPAP does not support routine use of CPAP for therapy of CSA in patients with heart failure.
On the other hand, a fall in AHI to <15 at 3 months after randomization was associated with a higher transplant-free survival in the CPAP-treated group than in the control group,[11] suggesting that marked lowering of the AHI may be a key therapeutic goal.
These observations suggest the potential for CPAP or other types of PAP, such as adaptive servo-ventilation (ASV), to improve outcomes in heart failure patients with CSA. Further trials are needed to test this hypothesis.
References
Bradley TD, Logan AG, Kimoff RJ, et al; CANPAP Investigators. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med. 2005;353:2025–2033.
Arzt M, Floras JS, Logan AG, et al; CANPAP Investigators. Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: A post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients With Central Sleep Apnea and Heart Failure Trial (CANPAP). Circulation 2007;115:3173−3180.