セキグチ　ハルキ   SEKIGUCHI Haruki   関口　治樹    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	A novel optimized adaptive servo-ventilation setting for a patient with severe heart failure based on the echocardiogram: a case report.
掲載誌名	正式名：European heart journal. Case reports 略　 称：Eur Heart J Case Rep ISSNコード：25142119/25142119
掲載区分	国外
巻・号・頁	6(3),pp.ytac074
著者・共著者	Haruki Sekiguchi†*, Sae Tanino, Naoki Serizawa, Nobuhisa Hagiwara
担当区分	筆頭著者,責任著者
発行年月	2022/03
概要	BACKGROUND:Adaptive servo-ventilation (ASV) is a non-invasive positive-pressure ventilation therapy considered beneficial for treating heart failure (HF) in patients with central sleep apnoea. However, to the best of our knowledge, there is no evidence indicating that this therapy increases the mortality in HF patients. We hypothesized that ASV settings are important for HF patients with reduced ejection fraction. Therefore, to determine the suitable ASV setting for such patients, we optimized these settings to improve the left ventricular (LV) output during the therapy.CASE SUMMARY:We present a case of HF caused by dilated cardiomyopathy in a 45-year-old man. He was hospitalized due to HF; his LV ejection fraction was ∼20%, and haemodynamics analysis revealed his HF grade was Forrester subset IV. During hospitalization, he was diagnosed with sleep apnoea; therefore, we induced ASV with our optimized setting using an echocardiogram evaluating stroke volume (SV). Using this method, we could determine the appropriate setting that increased his SV and improved his apnoea-hypopnoea index. At the 5th-year follow-up, he had no dyspnoea on effort (New York Heart Association Functional Classification I). He continued using the ASV with good adherence, and no hospitalization for ventricular arrhythmia and HF was reported.DISCUSSION:Our ASV optimized setting showed beneficial effects in an HF patient with reduced ejection fraction. This method improved the patient's SV and apnoea-hypopnoea index, indicating that this novel method should be considered for HF patients with reduced ejection fraction.
DOI	10.1093/ehjcr/ytac074
PMID	35350723