《Table 2 Short term randomized control trial investigating the effects of adaptive servo ventilation

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《Treatment of central sleep apnea in patients with heart failure: Now and future》

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1CAT-HF trial includes patients with predominant OSA in addition to predominant CSA（>70%patients had predominant CSA）.RCT:Randomized control trial；ASV:Adaptive servo ventilation；CPAP:Continuous positive airway pressure；HF:Heart failure；CSA:Central sleep

The Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo Ventilation in Patients with Heart Failure（SERVE-HF）trial was the largest RCT that investigated the effect of the CSA treatment in patients with HFrEF.It involved 1325 patients with predominant CSA and an AHI higher than 15events/h measured by home polygraphy.Participants were randomly allocated to either the minute volume of ventilation-triggered ASV（mv-ASV）group or to the medical therapy group.The primary endpoint was the composite of death from any cause，including cardiac transplantation，LV assist device（LVAD）implantation，resuscitation after sudden cardiac death，appropriate implanted defibrillator discharge for ventricular arrhythmia，or unplanted admission for worsening HF.Contrary to the expectations，the mv-ASV did not reduce the primary combinedendpoints[hazard ratio（HR）=1.13，95%CI:0.97-1.31；P=0.10]；however，most importantly，the mv-ASV group showed a significantly increased risk of“all-causes”death（HR=1.28，95%CI:1.06-1.55；P=0.01）and cardiovascular mortality（HR=1.34，95%%CI:1.09-1.65；P=0.006）compared to the control group，even though they only represent secondary endpoints（Table 4）[15].