SERVE-HF
Identifying which heart failure patients suffer from sleep apnoea is likely to increase treatment options. Our group is the UK lead centre for an international multi-centre randomised controlled trial of adaptive servo ventilation in heart failure patients with sleep disordered breathing: The SERVE-HF study is funded by a Fellowship from ResMed Inc.
Sleep disordered breathing is increasingly recognised as an important issue in patients with Chronic Heart Failure, a condition affecting 900,000 people in the UK and which therefore constitutes a significant health economic burden. The prognosis of heart failure has improved with the evolution of more sophisticated medications and implantable devices however survival rates still remain comparable with many common malignancies.
Sleep disordered breathing comprises both obstructive and central sleep disordered breathing and is found in over half of all patients with heart failure, regardless of the severity of their condition. There is good observational data to suggest that the presence of either form of sleep disordered breathing worsens the prognosis in these patients and so it is increasingly acknowledged as a potentially important therapeutic target. As yet no treatment has been found which confers a survival benefit for affected patients. Our group forms part of the UK lead centre for the SERVE-HF study; a randomised controlled trial of patients with central sleep disordered breathing and heart failure which aims to see if the use of adaptive servoventilation (a newer form of ventilation) confers a survival benefit. There are currently over 60 participating centres world wide and recruitment started internationally in the summer of 2007 and at the Royal Brompton hospital a year later.
Collaborations: Professor Martin Cowie and Dr Theresa McDonagh, Cardiology Department, Royal Brompton Hospital, Dr Stuart Rosen, Ealing Hospital and Dr H McIntyre Conquest Hospital, Hastings.
Selected publications
Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK. A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction. Eur J Heart Fail. 9: 243-50, 2007
Rao A, Georgiadou P, Francis DP, Johnson A, Kremastinos DT, Simonds AK, Coats AJ, Cowley A, Morrell MJ. Sleep-disordered breathing in a general heart failure population: relationships to neurohumoral activation and subjective symptoms. J Sleep Res. 15:81-8, 2006
Hastings PC, Vazir A, O'Driscoll DM, Morrell MJ, Simonds AK. Symptom burden of sleep-disordered breathing in mild-to-moderate congestive heart failure patients. Eur Respir J. 27:748-55, 2006.
