Treatment of sleep apnea in heart failure patients after SERVE-HF results
|
|
- Jeffry Maxwell
- 6 years ago
- Views:
Transcription
1 Treatment of sleep apnea in heart failure patients after SERVE-HF results Martin R Cowie Professor of Cardiology National Heart & Lung Institute Imperial College London (Royal Brompton Hospital Campus)
2 Declaration of interests Research grants from ResMed, Boston Scientific, St Jude Medical, Bayer Consultancy advice and speaker s fees from Medtronic, ResMed, Boston Scientific, St Jude Medical, Respicardia, Sorin, Servier, Pfizer, Novartis, Daiichi-Sankyo Co-Principal Investigator of SERVE-HF Study (NCT )
3
4 Airflow Impedance It is easy to screen for SDB
5 SDB prevalence and type varies by HF symptom severity Oldenburg et al. Eur J Heart Fail 2007;9:251-7
6 Does treatment of sleep apnea really make a difference in heart failure?
7 Building the evidence 2005 CANPAP trial: CPAP treatment of CSA/CSR in HF patients (n=258) 1 Improvements in LVEF, plasma BNP levels, and functional outcomes No beneficial effect on hospitalization, quality of life, or survival 1. Bradley et al. NEJM 2005;353:
8 Building the evidence 2007 CANPAP post-hoc analysis suggested that CPAP might improve mortality when CSA is controlled (AHI <15/h) in HF patients with CSA and ejection fraction <40% 1 * Unadjusted p= Arzt et al. Circulation 2007;115:
9 Using more modern technologies? ASV is more effective than CPAP for treating CSA/CSR 1,2 HF patients comply better with ASV vs CPAP therapy 2,3 Patients prefer ASV over both CPAP and bilevel PAP 1 1. Teschler et al. AJRCCM 2001;164:614-9; 2. Philippe et al. Heart 2006;92:337; 3. Kasai et al. Circ Heart Fail 2010;3:140-8.
10 SERVE HF: Objective To investigate the effects of adding ASV to guideline-based medical management on survival and cardiovascular outcomes in patients with heart failure with reduced ejection fraction (HFrEF) and predominant CSA 1,2 1. Cowie et al. Eur J Heart Fail 2013;15:937-43; 2. Cowie et al. NEJM 2015; 373:
11 SERVE-HF: Design 91 centres (Germany, France, Sweden, UK, Australia, Denmark, Norway, Czech Republic, Finland, Switzerland, Netherlands) Randomized, parallel, event-driven design Guideline-based medical management: Alone (control group) Plus ASV (Auto Set CS, ResMed) ASV titration in hospital (PG or PSG) Starting at default settings Expiratory positive airway pressure manually increased to control OSA and maximum pressure support increased to control CSA Cowie et al. Eur J Heart Fail 2013;15:937-43; Cowie et al. NEJM 2015; 373:
12 SERVE-HF: Patients Inclusion Criteria Age 22 years Chronic stable HF (ESC guidelines, no hospitalization within 4 weeks) LV dysfunction LVEF 45% NYHA class III or IV Or NYHA class II with 1 hospitalization for HF in previous 24 months Predominant CSA (AHI >15/h with 50% central events and central AHI 10/h Exclusion Criteria Significant COPD Oxygen saturation <90% at rest during the day Current use of positive airway pressure therapy Cardiac surgery or resynchronization therapy within the previous 6 months TIA or stroke in previous 3 months Significant valvular heart disease Contraindications to ASV 1325 patients enrolled between Feb 2008 and May 2013 Cowie et al. Eur J Heart Fail 2013;15:937-43; Cowie et al. NEJM 2015; 373:
13 Primary Endpoint (2015): Neutral Time to first event of all-cause death, life-saving cardiovascular intervention, or unplanned hospitalization for worsening chronic HF Cowie et al. NEJM 2015; 373:
14 Subgroup Analysis: 1 Endpoint Cowie et al. NEJM 2015; 373:
15 Cowie et al. NEJM 2015; 373: All-Cause Death
16 Cowie et al. NEJM 2015; 373: Cardiovascular Death
17 Subgroup Analysis: CV Death Cowie et al. NEJM 2015; 373:
18 Post-hoc Analysis Cardiovascular death without prior hospitalization for worsening heart failure Between-group difference in cardiovascular death was largely accounted for by death without prior hospitalization for worsening HF
19 8x more events than CANPAP 425 deaths 357 CV deaths 559 pts WHF hosp 20 heart tx 26 VAD Cowie et al. NEJM 2015; 373:
20 SERVE-HF more evidence to come MRI and biomarker sub-study Multi-state modelling On-treatment analysis ICD data analysis Sleep Study data analysis And many other topics.
21 SERVE (interim) conclusions Addition of ASV to guideline-based medical management does not improve morbidity and heart function in patients with HFrEF There is a safety signal for all-cause and cardiovascular mortality Significantly increased in the ASV group vs control Pathophysiology of the increased cardiovascular mortality remains to be elucidated: likely sudden death (?arrhythmic) The SERVE-HF results apply only to the population studied Cannot be generalised to patients with HF with preserved ejection fraction, acute HF, or those with predominant OSA Cowie et al. NEJM 2015; 373:
22 What might mechanisms of harm of (mask-based) therapy in CSR be? Naughton MT. Thorax 2012; 67: End-expiratory lung volume (and therefore oxygen stores) hyperventilation-associated vagal and sympathetic tone hyperventilation-associated respiratory alkalosis which may be protecting myocytes hyperventilation-associated intrathoracic pressure assist to cardiac pump action hyperventilation over-ride of bronchial oedema apnoea-associated 5-10mmHg intrinsic PEEP respiratory muscle fatigue due to abolishing apnoea
23 SERVE (interim) conclusions Addition of ASV to guideline-based medical management does not improve morbidity and heart function in patients with HFrEF There is a safety signal for all-cause and cardiovascular mortality Significantly increased in the ASV group vs control Pathophysiology of the increased cardiovascular mortality remains to be elucidated: likely sudden death (?arrhythmic) The SERVE-HF results apply only to the population studied Cannot be generalised to patients with HF with preserved ejection fraction, acute HF, or those with predominant OSA Cowie et al. NEJM 2015; 373:
24 Sub-group Analysis of Global Rank Endpoint Central SDB in hospitalised patients HFpEF HR (95%CI) p-value Global rank endpoint 0.38 (0.15, 0.98) NCT
25 ADVENT-HF more evidence to come NCT ASV effect on survival and hospital admission in heart failure LVEF 45%; AHI 15; ESS 10 OSA or CSA RCT Event driven: 540 endpoints death, or first hospitalisation, or onset of new Afib/flutter requiring anticoagulation, or appropriate ICD shock not leading to hospitalisation
26 Sleep Apnoea and Heart Failure Not airway pressure currently for CSA IF daytime sleepiness and severe OSA treat with CPAP Individualised approach consult the sleep/resp physician What to do?
Martin R Cowie Professor of Cardiology, National Heart & Lung Institute Imperial College London (Royal Brompton Hospital)
Treatment of Sleep-Disordered Breathing With Predominant Central Sleep Apnoea by Adaptive Servo Ventilation in Patients With Heart Failure and Reduced Ejection Fraction (SERVE-HF) Martin R Cowie Professor
More informationSlide 1. Slide 2 Declaration of Interests. Slide 3. Case study #1. Heart Failure and Sleep Apnoea. 47 year old BMI 32 Treated HBP Type 2 DM
Slide 1 Heart Failure and Sleep Apnoea Martin R Cowie MD MSc FRCP FRCP (Ed) FESC Professor of Cardiology, Imperial College London m.cowie@imperial.ac.uk @ProfMartinCowie Slide 2 Declaration of Interests
More informationEdoardo Gronda UO cardiologia e Ricerca Dipartimento Cardiovascolare IRCCS MultiMedica
Convegno Pneumologia 2016 Milano 16-18 giugno 2016 Centro Congressi Palazzo delle Stelline Edoardo Gronda UO cardiologia e Ricerca Dipartimento Cardiovascolare IRCCS MultiMedica Central apnea 10 second
More informationHealth Care Providers:
Health Care Providers: 1. What is SERVE-HF? SERVE-HF is a multinational, multi-center, randomized controlled trial designed to assess whether treatment of predominantly Central Sleep Apnea with Adaptive
More informationSleep Disordered Breathing: Beware Snoring! Dr T A McDonagh Consultant Cardiologist Royal Brompton Hospital London. UK
Sleep Disordered Breathing: Beware Snoring! Dr T A McDonagh Consultant Cardiologist Royal Brompton Hospital London. UK Sleep Disordered Breathing in CHF Erratic breathing during sleep known for years e.g.
More informationObrigada por ver esta apresentação. Lembramos que esta apresentação é propriedade do autor
Obrigada por ver esta apresentação Lembramos que esta apresentação é propriedade do autor É-lhe proporcionada pela Associação Portuguesa de Sono no contexto da Lufada 2016, para seu uso pessoal, tal como
More informationApnea-Hypopnea- Index The new old biomarker for Sleep-Disordered Breathing. Alan S Maisel MD
Apnea-Hypopnea- Index The new old biomarker for Sleep-Disordered Breathing Alan S Maisel MD Triumvirate of Health-public awareness 1.8% Sleep Physical Fitness Nutrition 91.3% 99.9% Sleep is important to
More informationChronic NIV in heart failure patients: ASV, NIV and CPAP
Chronic NIV in heart failure patients: ASV, NIV and CPAP João C. Winck, Marta Drummond, Miguel Gonçalves and Tiago Pinto Sleep disordered breathing (SDB), including OSA and central sleep apnoea (CSA),
More informationSlide 1. Slide 2. Slide 3. Managing Acute Heart Failure Trials and Tribulations. Declaration of
Slide 1 Managing Acute Heart Failure Trials and Tribulations Martin R Cowie MD MSc FRCP FRCP (Ed) FESC Professor of Cardiology, Imperial College London m.cowie@imperial.ac.uk @ProfMartinCowie Slide 2 Declaration
More informationRemote management of heart failure using implanted devices and formalized follow-up procedures (REM-HF)
Remote management of heart failure using implanted devices and formalized follow-up procedures (REM-HF) Martin R Cowie Professor of Cardiology, Imperial College London (Royal Brompton Hospital) London,
More informationSleep Apnea and chronic Heart Failure
ESC CONGRESS 2012 Sleep Apnea and chronic Heart Failure Prof. Dr. med. Michael Arzt Schlafmedizinisches Zentrum Klinik und Poliklinik für Innere Medizin II Universitätsklinikum Regensburg michael.arzt@klinik.uni-regensburg.de
More informationA Deadly Combination: Central Sleep Apnea & Heart Failure
A Deadly Combination: Central Sleep Apnea & Heart Failure Sanjaya Gupta, MD FACC FHRS Ohio State University Symposium May 10 th, 2018 Disclosures Boston Scientific: fellowship support, speaking honoraria
More informationShahrokh Javaheri, MD
Central Sleep Apnea Shahrokh Javaheri, MD Sleep Physician Bethesda North Hospital Professor Emeritus of Medici University of Cincinnati, Cincinnati, Ohio Adjunct Professor of Medicine, Division of Cardiology,
More informationCentral Sleep Apnoea during CPAP therapy First insights from a big data analysis. April 2018
Central Sleep Apnoea during CPAP therapy First insights from a big data analysis April 2018 Agenda Lexicon Introduction to Big Data The findings of the Trajectories of Emergent Central Sleep Apnea during
More informationSleep and the Heart. Sleep Stages. Sleep and the Heart: non REM 8/31/2016
Sleep and the Heart Overview of sleep Hypertension Arrhythmias Ischemic events CHF Pulmonary Hypertension Cardiac Meds and Sleep Sleep Stages Non-REM sleep(75-80%) Stage 1(5%) Stage 2(50%) Stage 3-4*(15-20%)
More informationHeart Failure and Sleep Disordered Breathing (SDB) Unhappy Bedfellows
Question Heart Failure and Sleep Disordered Breathing (SDB) Unhappy Bedfellows 1 ResMed 2012 07 2 ResMed 2012 07 Open Airway 3 ResMed 2012 07 Flow Limitation Snore 4 ResMed 2012 07 Apnoea 5 ResMed 2012
More informationCPAP vs ASV for Heart Failure TSANZ, Gold Coast Matthew T. Naughton MD FRACP Melbourne, Australia. Outline
CPAP vs ASV for Heart Failure TSANZ, Gold Coast 2015 Matthew T. Naughton MD FRACP Melbourne, Australia Outline What is Adaptive Servo Controlled Ventilation (ASV)? Pressure and Volume Aetiology: Chronic
More informationUPDATES IN MANAGEMENT OF HF
UPDATES IN MANAGEMENT OF HF Jennifer R Brown MD, MS Heart Failure Specialist Medstar Cardiology Associates DC ACP Meeting Fall 2017 Disclosures: speaker bureau for novartis speaker bureau for actelion
More informationSleep Apnea and Heart Failure
Sleep Apnea and Heart Failure Micha T. Maeder, MD Cardiology Division Kantonsspital St. Gallen Switzerland micha.maeder@kssg.ch Sleep Disordered Breathing (SDB) in HFrEF 700 HFrEF patients (LVEF
More informationUpdates in Congestive Heart Failure
Updates in Congestive Heart Failure GREGORY YOST, DO JOHNSTOWN CARDIOVASCULAR ASSOCIATES 1/28/2018 Disclosures Edwards speaker on Sapien3 valves (TAVR) Stages A-D and NYHA Classes I-IV Stage A: High risk
More informationPost Hoc Analysis of the PARADIGM Heart Failure Trial:
Post Hoc Analysis of the PARADIGM Heart Failure Trial: Pulse Pressure and Outcomes in Heart Failure with Reduced Ejection Fraction Chen-Huan Chen, M.D. Professor, Department of Medicine, National Yang-Ming
More informationIn-Patient Sleep Testing/Management Boaz Markewitz, MD
In-Patient Sleep Testing/Management Boaz Markewitz, MD Objectives: Discuss inpatient sleep programs and if they provide a benefit to patients and sleep centers Identify things needed to be considered when
More informationWhat s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE. Marc Ferrini (Lyon Fr)
What s new in 2016 Guidelines of the European Society of Cardiology? HEART FAILURE Marc Ferrini (Lyon Fr) Palermo (I) 1 04 2017 Consulting Fees, Honoraria: BAYER PHARMA BOEHRINGER INGELHEIM BRISTOL MEYERS
More informationNovel pathophysiological concepts for the development and impact of sleep apnea in CHF.
Olaf Oldenburg Novel pathophysiological concepts for the development and impact of sleep apnea in CHF. Sleep apnea the need to synchronize the heart, the lung and the brain. Heart Failure 2011 Gothenburg,
More informationΤεχνολογικές εξελίξεις & καινοτοµίες στις συσκευές βηµατοδότησης & απινίδωσης
Τεχνολογικές εξελίξεις & καινοτοµίες στις συσκευές βηµατοδότησης & απινίδωσης Georgios Giannopoulos, MD, FESC Cardiology Dept., Athens General Hospital G. Gennimatas, Athens, Greece Adj. Asst. Professor
More informationACE inhibitors: still the gold standard?
ACE inhibitors: still the gold standard? Session: Twenty-five years after CONSENSUS What have we learnt about the RAAS in heart failure? Lars Køber, MD, D.Sci Department of Cardiology Rigshospitalet University
More informationSaudi Arabia February Pr Michel KOMAJDA. Université Pierre et Marie Curie Hospital Pitié Salpétrière
Prevention of Cardiovascular events with Ivabradine: The SHIFT Study Saudi Arabia February 2011 Pr Michel KOMAJDA Université Pierre et Marie Curie Hospital Pitié Salpétrière Paris FRANCE Declaration Of
More informationHFpEF 2016 : Comorbidities and Outcomes
HFpEF 2016 : Comorbidities and Outcomes Christopher M. O Connor, MD, FACC CEO and Executive Director, Inova Heart and Vascular Institute Professor of Medicine, Duke University Editor in Chief, JACC: Heart
More informationCentral sleep apneas: Definition, etiology and evidence based management Dr Nandakishore B
Central sleep apneas: Definition, etiology and evidence based management 30-10-2015 Dr Nandakishore B Overview of the seminar Introduction Classification of CSA Pathophysiology Evidence based management
More informationHeart Failure with Preserved EF (HFPEF) Epidemiology and management
Heart Failure with Preserved EF (HFPEF) Epidemiology and management Karl Swedberg Senior Professor of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden e-mail: karl.swedberg@gu.se
More informationW J R. World Journal of Respirology. Effectiveness of adaptive servo-ventilation. Abstract REVIEW. Yasuhiro Tomita, Takatoshi Kasai
W J R World Journal of Respirology Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.5320/wjr.v5.i2.112 World J Respirol 2015 July 28; 5(2): 112-125
More informationCombination of renin-angiotensinaldosterone. how to choose?
Combination of renin-angiotensinaldosterone system inhibitors how to choose? Karl Swedberg Professor of Medicine Sahlgrenska Academy University of Gothenburg karl.swedberg@gu.se Disclosures Research grants
More informationThe ACC Heart Failure Guidelines
The ACC Heart Failure Guidelines Fakhr Alayoubi, Msc,R Ph President of SCCP Cardiology Clinical Pharmacist Assistant Professor At King Saud University King Khalid University Hospital Riyadh-KSA 2017 ACC/AHA/HFSA
More informationAbout VirtuOx. Was marketed exclusively by Phillips Healthcare division, Respironics for 3 years
About VirtuOx VirtuOx, Inc. assists physicians and Durable Medical Equipment (DME)( companies diagnose respiratory diseases and qualify patients for home respiratory equipment under the guidelines of CMS
More informationFundamentals of Central Sleep Apnea. Emerson Kerr RRT, RPSGT Sr. Field Marketing Manager, North America
Fundamentals of Central Sleep Apnea Emerson Kerr RRT, RPSGT Sr. Field Marketing Manager, North America Sleep Disordered Breathing Prevalence Estimate prevalence : 100 million world wide 1 of every 5 adults
More informationAdaptive servo ventilation improves cardiac pre and after load in heart failure patients with Cheyne-Stokes respiration
Adaptive servo ventilation improves cardiac pre and after load in heart failure patients with Cheyne-Stokes respiration Makiko Miyata, Akiomi Yoshihisa, Takamasa Sato, Satoshi Suzuki, Koichi Sugimoto,
More informationSleep Disordered Breathing and HH with Preserved Ejection Fraction:
Sleep Disordered Breathing and HH with Preserved Ejection Fraction: Pr Thibaud DAMY Heart Failure Unit Department of Cardiology CHU Mondor, Créteil, France Definition of HF-PEF The diagnosis of HF-PEF
More informationSystolic and Diastolic Dysfunction: Four Upcoming Challenges
Systolic and Diastolic Dysfunction: Four Upcoming Challenges Promoting Early Detection HFrEF: Beyond Neprilysin/Enalapril HFmrEF: What Is It and How Does One Manage It? HFpEF: Etiopathogenetic Role and
More informationA Global perspective on Heart Failure: What needs to change? Martin R Cowie London, United Kingdom
A Global perspective on Heart Failure: What needs to change? Martin R Cowie London, United Kingdom Global perspective on heart failure: what needs to change? Martin R Cowie Professor of Cardiology National
More informationMario Kinsella MD FAASM 10/5/2016
Mario Kinsella MD FAASM 10/5/2016 Repetitive episodes of apnea or reduced airflow Due to upper airway obstruction during sleep Patients often obese Often have hypertension or DM 1 Obstructive apneas, hypopneas,
More informationClinical update of BiPAP autosv for treatment of Sleep Disordered Breathing
BiPAP autosv Advanced System One Authors: Dr. Teofilo Lee-Chiong, Medical Liaison, Philips Respironics Cheryl Needham, Senior Clinical Marketing Manager, Philips Respironics Bill Hardy, Senior Scientific
More informationSleep-related Breathing Disorders Adaptive Servo-Ventilation
Current and Future Use of Adaptive Servo-Ventilation Marie-Pia d Ortho, 1,2 Holger Woehrle 3,4 and Michael Arzt 5 1. University Paris Diderot, UFR de Médicine, Sorbonne Paris Cité, Paris, France; 2. Hôpital
More informationTaking the FAILURE out of CHF Denzil Moraes, MD, FACC
Taking the FAILURE out of CHF Denzil Moraes, MD, FACC Our Lady of the Lake Heart & Vascular Institute CHAIR Heart Failure Committee The Burden of Heart Failure Prevalence of Heart Failure ~ Currently 5.7
More informationSleep Apnea Treatment Options, A Year After ASV
Sleep Apnea Treatment Options, A Year After ASV Nancy Collop, MD, FAASM Emory University Associated Professional Sleep Societies, LLC 1 Conflict of Interest Disclosures for Speakers x 1. I do not have
More informationDATE: 07 August 2012 CONTEXT AND POLICY ISSUES
TITLE: Adaptive Servo Ventilation versus Continuous or Bi-Level Positive Airway Pressure: A Review of the Clinical Effectiveness, Cost-Effectiveness and Guidelines DATE: 07 August 2012 CONTEXT AND POLICY
More informationPortable Sleep Testing in Hospitalized Patients
1 Portable Sleep Testing in Hospitalized Patients Rami Khayat, MD Heart Failure AND Public Health 6 million Americans with heart failure (>2% population 20 million people with asymptomatic cardiac impairment
More informationBest Match. Non-Invasive Ventilation. WSS Fall Objectives. BiPAP AVAPS Patient Types 9/10/2018. Advanced Algorithms - Clinical Applications
WSS Fall 2018 Advanced Algorithms - Clinical Applications Average Volume Assured Ventilation (AVAPS) Auto Servo Ventilation (SV) Hank Hart BS, LPN Objectives Differentiate between BiPAP AVAPS and BiPAP
More informationHeart Failure. GP Update Refresher 18 th January 2018
GP Update Refresher 18 th January 2018 Heart Failure Dr. Alexander Lyon Senior Lecturer and Consultant Cardiologist Clinical Lead in Cardio-Oncology Royal Brompton Hospital, London UK President of British
More informationFrom PARADIGM-HF to Clinical Practice. Waleed AlHabeeb, MD, MHA Associate Professor of Medicine President of the Saudi Heart Failure Group
From PARADIGM-HF to Clinical Practice Waleed AlHabeeb, MD, MHA Associate Professor of Medicine President of the Saudi Heart Failure Group PARADIGM-HF: Inclusion Criteria Chronic HF NYHA FC II IV with LVEF
More information2016 ESC Heart Failure Guidelines: what is new? Piotr Ponikowski Wroclaw, Poland
2016 ESC Heart Failure Guidelines: what is new? Piotr Ponikowski Wroclaw, Poland Disclosures Consultancy fees and speaker s honoraria from: Amgen, Servier, Novartis, Johnson & Johnson, Merck, Berlin Chemie,
More informationTherapeutic Targets and Interventions
Therapeutic Targets and Interventions Ali Valika, MD, FACC Advanced Heart Failure and Pulmonary Hypertension Advocate Medical Group Midwest Heart Foundation Disclosures: 1. Novartis: Speaker Honorarium
More informationHF and CRT: CRT-P versus CRT-D
HF and CRT: CRT-P versus CRT-D Andrew E. Epstein, MD Professor of Medicine, Cardiovascular Division University of Pennsylvania Chief, Cardiology Section Philadelphia VA Medical Center Philadelphia, PA
More informationTrials and Tribulations of Investigator Initiated RCTs: A Study Chair s Perspective
Trials and Tribulations of Investigator Initiated RCTs: A Study Chair s Perspective Douglas Bradley, MD Director, Division of Respirology, University of Toronto Clifford Nordal Chair in Sleep Apnea and
More informationSleep-disordered Breathing in Heart Failure Current State of the Art
Sleep-disordered Breathing in Current State of the Art Martin R Cowie, 1 Holger Woehrle, 2,3 Olaf Oldenburg, 4 Thibaud Damy, 5 Peter van der Meer, 6 Erland Erdman, 7 Marco Metra, 8 Faiez Zannad, 9 Jean-Noel
More informationThe role of remote monitoring in preventing readmissions after acute heart failure
The role of remote monitoring in preventing readmissions after acute heart failure October 20, 2017 Randall C Starling MD MPH FACC FAHA FESA FHFSA Professor of Medicine Kaufman Center for Heart Failure
More informationSummary/Key Points Introduction
Summary/Key Points Introduction Scope of Heart Failure (HF) o 6.5 million Americans 20 years of age have HF o 960,000 new cases of HF diagnosed annually o 5-year survival rate for HF is ~50% Classification
More informationRal Antic Director Thoracic Medicine Head of Sleep Service Royal Adelaide Hospital. Visiting Respiratory and Sleep Physician Alice Springs Hospital
Ral Antic Director Thoracic Medicine Head of Sleep Service Royal Adelaide Hospital Visiting Respiratory and Sleep Physician Alice Springs Hospital Conflict of Interest Past member of ResMed Medical Board
More informationPolypharmacy - arrhythmic risks in patients with heart failure
Influencing sudden cardiac death by pharmacotherapy Polypharmacy - arrhythmic risks in patients with heart failure Professor Dan Atar Head, Dept. of Cardiology Oslo University Hospital Ullevål Norway 27.8.2012
More informationObstructive Sleep Apnea
Obstructive Sleep Apnea Definition: Repetitive episodes of upper airway obstruction (complete or partial) that occur during sleep and are associated with arousals or desaturations +/or daytime sleepiness.
More informationCircadian Variations Influential in Circulatory & Vascular Phenomena
SLEEP & STROKE 1 Circadian Variations Influential in Circulatory & Vascular Phenomena Endocrine secretions Thermo regulations Renal Functions Respiratory control Heart Rhythm Hematologic parameters Immune
More informationShould I use statins?
I know the trials in heart failure but how do I manage my patient? Should I use statins? Aldo P Maggioni, MD, FESC ANMCO Research Center Firenze, Italy Disclosures Aldo P Maggioni served as a member of
More informationSleep and the Heart. Physiologic Changes in Cardiovascular Parameters during Sleep
Sleep and the Heart Rami N. Khayat, MD Professor of Internal Medicine Medical Director, Department of Respiratory Therapy Division of Pulmonary, Critical Care and Sleep Medicine The Ohio State University
More informationSleep and the Heart. Rami N. Khayat, MD
Sleep and the Heart Rami N. Khayat, MD Professor of Internal Medicine Medical Director, Department of Respiratory Therapy Division of Pulmonary, Critical Care and Sleep Medicine The Ohio State University
More informationWhat s new in the 2017 heart failure guidelines. Prof.Dr.Mehmet Birhan YILMAZ, FESC, FACC, FHFA
What s new in the 2017 heart failure guidelines Prof.Dr.Mehmet Birhan YILMAZ, FESC, FACC, FHFA Key points to remember 2017 guidelines recommend using natriuretic peptides as biomarkers to screen for heart
More informationjournal of medicine The new england Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure abstract
The new england journal of medicine established in 1812 September 17, 2015 vol. 373 no. 12 Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure Martin R. Cowie, M.D., Holger Woehrle,
More informationOSA and COPD: What happens when the two OVERLAP?
2011 ISRC Seminar 1 COPD OSA OSA and COPD: What happens when the two OVERLAP? Overlap Syndrome 1 OSA and COPD: What happens when the two OVERLAP? ResMed 10 JAN Global leaders in sleep and respiratory medicine
More informationΣύνδρομο σπνικής άπνοιας. Ποιός o ρόλος ηοσ ζηη γένεζη και ανηιμεηώπιζη ηων αρρσθμιών;
Σύνδρομο σπνικής άπνοιας. Ποιός o ρόλος ηοσ ζηη γένεζη και ανηιμεηώπιζη ηων αρρσθμιών; E.N. Σημανηηράκης MD, FESC Επίκ. Καθηγηηής Καρδιολογίας Πανεπιζηημιακό Νοζοκομείο Ηρακλείοσ Epidemiology 4% 2% 24%
More informationPrevalence of Sleep Disordered Breathing in Congestive Heart Failure as Determined by ApneaLink, a Simplified Screening Device
Prevalence of Sleep Disordered Breathing in Congestive Heart Failure as Determined by ApneaLink, a Simplified Screening Device Susan R. Isakson, BS, 1 Jennifer Beede, BS, 1 Kevin Jiang, BS, 1 Nancy J.
More informationa new beginning in managing CSA ResMed.com/AirSolutions
a new beginning in managing CSA ResMed.com/AirSolutions As your partner in patient care, ResMed gives you more clinical tools to manage patients with breathing disorders that can sometimes be challenging
More informationCOMPLEX SLEEP APNEA IS IT A DISEASE? David Claman, MD UCSF Sleep Disorders Center
COMPLEX SLEEP APNEA IS IT A DISEASE? David Claman, MD UCSF Sleep Disorders Center CENTRAL APNEA Central Apnea Index > 5 ( >50% of apnea are central) Mayo Clinic Proc 1990; 65:1255 APNEA AT SLEEP ONSET
More informationDebate PRO. Dronedarone is an important drug in the management of paroxysmal atrial fibrillation. John Camm
ESC ICM - Internationales Congress Center München 2012 Atrial Fibrillation Controversies in Medical Treatment Debate Dronedarone is an important drug in the management of paroxysmal atrial fibrillation
More informationHeart Failure with preserved ejection fraction (HFpEF)
Heart Failure with preserved ejection fraction (HFpEF) Dr. Pierpaolo Pellicori Hull York Medical School Kingston-upon-Hull United Kingdom Conflict of interest: none Heart failure is a contemporary problem
More informationThis study was supported in part by a research grant from the Fukuda Foundation for Medical Technology in Tokyo.
Short Term Effect of Adaptive Servo- Ventilation Compared with Continuous Positive Airway Pressure on Muscle Sympathetic Nerve Activity in Patients with Heart Failure This study was supported in part by
More informationJoo-Yong Hahn, MD/PhD
Sungkyunkwan University School of Medicine Joo-Yong Hahn, MD/PhD Heart Vascular Stork Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Grant support Korean Society of Interventional
More informationWHAT S NEW IN HEART FAILURE
WHAT S NEW IN HEART FAILURE Drugs, Devices and Diagnostics John M. Herre, MD, FACC, FACP Director, Advanced Heart Failure Program Sentara Helathcare Professor of Medicine Eastern Virginia Medical School
More informationNew evidences in heart failure: the GISSI-HF trial. Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy
New evidences in heart failure: the GISSI-HF trial Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy % Improving survival in chronic HF and LV systolic dysfunction: 1 year all-cause mortality 20
More informationHEART FAILURE. F. Ruschitzka (Zurich, CH) ESC CONGRESS HIGHLIGHTS
ESC CONGRESS HIGHLIGHTS HEART FAILURE F. Ruschitzka (Zurich, CH) Professor of Cardiology Co-Head, Dept of Cardiology President-elect HFA University Heart Center University Hospital Zürich, Switzerland
More informationJoel Reiter*, Bashar Zleik, Mihaela Bazalakova, Pankaj Mehta, Robert Joseph Thomas
Joel Reiter*, Bashar Zleik, Mihaela Bazalakova, Pankaj Mehta, Robert Joseph Thomas Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA *ומעבדת השינה הדסה עין כרם, ירושלים חיפפ ירושלים,
More informationChoosing the Appropriate Mode of PAP Therapy in the Perioperative Setting
Choosing the Appropriate Mode of PAP Therapy in the Perioperative Setting Lisa F. Wolfe MD Northwestern University Chicago, Illinois Choosing the Appropriate Mode of PAP Therapy in the Perioperative Setting
More informationThe Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF)
The Approach to Patients with Heart Failure and Mid-Range (40-50%) Ejection Fraction (HFmrEF) 22 nd Annual Heart Failure 2018 an Update on Therapy April 21, 2018 Los Angeles, CA Barry Greenberg, M.D. Distinguished
More informationComplex Sleep Apnea. Can we do better? David Weed D.O.,FCCP,FAASM. September 8, 2016
Complex Sleep Apnea Can we do better? David Weed D.O.,FCCP,FAASM September 8, 2016 If you don t know where you are going, you ll end up somewhere else. Yogi Berra Objectives Discuss what syndromes comprise
More informationUpper Airway Muscle Stimulation for Obstructive Sleep Apnea
Upper Airway Muscle Stimulation for Obstructive Sleep Apnea M. Safwan Badr, MD, MBA Chair, Department of Medicine, Wayne State University School of Medicine. Staff Physician, John D. Dingell VA Medical
More informationIntegration of diagnostic device information to improve patient management
Integration of diagnostic device information to improve patient management Haran Burri Associate Professor Cardiology Service University Hospital of Geneva Disclosures Biotronik: fellowship support, speaker
More informationHF-PEF: Symptoms, quality of life and mortality/morbidity
HF-PEF: Symptoms, quality of life and mortality/morbidity May 21, 2011 John McMurray, MD Eugene Braunwald Scholar in Cardiovascular Diseases, Brigham & Women s Hospital Boston; Visiting Professor of Medicine,
More informationDiagnosis is it really Heart Failure?
ESC Congress Munich - 25-29 August 2012 Heart Failure with Preserved Ejection Fraction From Bench to Bedside Diagnosis is it really Heart Failure? Prof. Burkert Pieske Department of Cardiology Med.University
More informationEffects of heart rate reduction with ivabradine on left ventricular remodeling and function:
Systolic Heart failure treatment with the If inhibitor ivabradine Trial Effects of heart rate reduction with ivabradine on left ventricular remodeling and function: results of the SHIFT echocardiography
More informationFA et Apnée du Sommeil
FA et Apnée du Sommeil La Réunion Octobre 2017 Pascal Defaye CHU Grenoble-Alpes Obstructive Sleep Apnea and AF Incidence of atrial fibrillation (AF), based on presence or absence of OSA. Cumulative frequency
More informationImplantation of a CRT-Pacemaker Rather than CRT-Defibrillator is Usually Preferred
Implantation of a CRT-Pacemaker Rather than CRT-Defibrillator is Usually Preferred Professor John GF Cleland University of Hull Kingston-upon-Hull United Kingdom Conflict of Interest: Funding or Speakers
More informationLIVE WEBINAR Boston Scientific External Use. Show and Distribute CRM AA-June 2017
LIVE WEBINAR www.hf-channel.com 1 LIVE WEBINAR AGENDA 2 The use of diagnostics in the management of HF Patients Prof. Martin Cowie 3 The patient journey is complex 4 Remote monitoring Initially, telephone
More informationIron Deficiency: New Therapeutic Target in Heart Failure. Stefan D. Anker, MD PhD
Iron Deficiency: New Therapeutic Target in Heart Failure Stefan D. Anker, MD PhD Department of Cardiology, Applied Cachexia Research, Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Germany.
More informationBi-Level Therapy: Boosting Comfort & Compliance in Apnea Patients
Bi-Level Therapy: Boosting Comfort & Compliance in Apnea Patients Objectives Describe nocturnal ventilation characteristics that may indicate underlying conditions and benefits of bilevel therapy for specific
More informationUpdate on pharmacological treatment of heart failure. Aldo Pietro Maggioni, MD, FESC ANMCO Research Center Firenze, Italy
Update on pharmacological treatment of heart failure Aldo Pietro Maggioni, MD, FESC ANMCO Research Center Firenze, Italy Presenter Disclosures Dr. Maggioni : Serving in Committees of studies sponsored
More informationHEART FAILURE. M KOMAJDA (Paris, F) F. RUSCHITZKA (Zurich, CH) ESC CONGRESS HIGHLIGHTS
ESC CONGRESS HIGHLIGHTS HEART FAILURE M KOMAJDA (Paris, F) F. RUSCHITZKA (Zurich, CH) Conflicts of Interest Aventis, Bayer, Biotronik, Cardiorentis, Merck, Novartis, Pfizer, SJM, Servier Interest in Conflict:
More informationResearch Article Improvement of Oxygen Saturation Levels is Associated with Response to Adaptive Servo- Ventilation Therapy in Heart Failure Patients
IBIMA Publishing JMED Research http://www.ibimapublishing.com/journals/jmed/jmed.html Vol. 2014 (2014), Article ID 188674, 12 pages Research Article Improvement of Oxygen Saturation Levels is Associated
More informationHeart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre
Heart Failure in Women: More than EF? Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Overview Review pathophysiology as it relates to diagnosis and management Rational approach to workup:
More informationEfficacy of beta-blockers in heart failure patients with atrial fibrillation: An individual patient data meta-analysis
Efficacy of beta-blockers in heart failure patients with atrial fibrillation: An individual patient data meta-analysis Dipak Kotecha, MD PhD on behalf of the Selection of slides presented at the European
More informationAll About Positive Airway Pressure (PAP) Therapy
All About Positive Airway Pressure (PAP) Therapy Nitipatana Chierakul Division of Respiratory Disease and Tuberculosis, Department of Medicine, Siriraj Medical School Siriraj Sleep Center: Fiscal-year
More informationCPAP. The CPAP will be covered
CPAP CPAP Did your patient have a face to face visit with the physician prior to having a sleep study that documented (1) Sleep History and symptoms and/or (2) Epworth Scale and/or (3) Physical Examination?
More informationPRO. HF treatment can reduce the risk of stroke. Wolfram Doehner, PD, PhD
ESC Council on Stroke ESC Heart & Brain Workshop Prague, January 2018 HF treatment can reduce the risk of stroke PRO Wolfram Doehner, PD, PhD Center for Stroke Research Berlin & Department of Cardiology,
More informationRecognition and Management of High Loop Gain Sleep Apnea
Recognition and Management of High Loop Gain Sleep Apnea Robert Joseph Thomas, M.D. Beth Israel Deaconess Medical Center, Boston, MA 02215 Associate Professor of Medicine, Harvard Medical School NEPS 2016
More information