{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:00:51Z","timestamp":1769108451175,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":770,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Philips Home Healthcare Solutions"},{"DOI":"10.13039\/100020974","name":"Philips Respironics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020974","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003305","name":"ResMed Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003305","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003042","name":"Else-Kroener Fresenius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020974","name":"Philips Respironics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020974","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003305","name":"ResMed Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003305","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to assess the effectiveness of adaptive servo-ventilation (ASV) for lowering hypoxaemic burden components in heart failure with reduced ejection fraction (HFrEF) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Fifty-six stable HFrEF patients with left ventricular ejection fraction \u2264 40 were randomized to receive either ASV (n = 27; 25 males) or optimal medical management or optimal medical management alone (n = 29; 26 males). Patients underwent overnight polysomnography at baseline and a 12 week follow-up visit. We quantified hypoxaemic as time spent at &amp;lt;90% oxygen saturation (T90) decomposed into desaturation-related components (T90desaturation) and non-specific drifts (T90non-specific). In the ASV arm, T90 significantly shortened by nearly 60% from 50.1 \u00b1 95.8 min at baseline to 20.5 \u00b1 33.0 min at follow-up compared with 59.6 \u00b1 88 and 65.4 \u00b1 89.6 min in the control arm (P = 0.009). ASV reduced the apnoea-related component (T90desaturation) from 37.7 \u00b1 54.5 to 2.1 \u00b1 7.3 min vs. 37.7 \u00b1 54.5 and 40.4 \u00b1 66.4 min in the control arm (P = 0.008). A significant non-specific T90 component of 19.6 \u00b1 31.8 min persisted during ASV. In adjusted multivariable regression, T90desaturation was significantly associated with the ratio of the forced expiratory volume in the first second to the forced vital capacity of the lungs (\u03b2 = 0.336, 95% confidence interval 0.080 to 0.593; P = 0.011) and T90non-specific with left ventricular ejection fraction (\u03b2 = \u22120.345, 95% confidence interval \u22120.616 to \u22120.073; P = 0.014).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ASV effectively suppresses the sleep apnoea-related component of hypoxaemic burden in HFrEF patients. A significant hypoxaemic burden not directly attributable to sleep apnoea but related to the severity of heart failure remains and may adversely affect cardiovascular long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14556","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T01:40:27Z","timestamp":1696470027000},"page":"3725-3728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hypoxaemic Burden in Heart Failure Patients Receiving Adaptive Servo-Ventilation"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-2167","authenticated-orcid":false,"given":"Mathias","family":"Baumert","sequence":"first","affiliation":[{"name":"Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide , Adelaide, SA, 5005 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute , Maastricht ,","place":["The Netherlands"]},{"name":"Centre for Heart Rhythm Disorders, The University of Adelaide and Royal Adelaide Hospital , Adelaide ,","place":["Australia"]},{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Donaustauf Hospital , Donaustauf ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Tafelmeier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Felfeli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Arzt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sobhan S.","family":"Shahrbabaki","sequence":"additional","affiliation":[{"name":"Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide , Adelaide, SA, 5005 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"key":"2026012113205008400_ehf214556-bib-0001","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.jacc.2021.05.048","article-title":"Sleep disordered breathing and cardiovascular disease: JACC state-of-the-art review","volume":"78","author":"Cowie","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026012113205008400_ehf214556-bib-0002","doi-asserted-by":"publisher","first-page":"4100","DOI":"10.1002\/ehf2.14027","article-title":"Prevalence and predictors of sleep-disordered breathing in chronic heart failure: The SchlaHF-XT registry","volume":"9","author":"Arzt","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2026012113205008400_ehf214556-bib-0003","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00959-2016","article-title":"Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep","volume":"49","author":"Randerath","year":"2017","journal-title":"Eur Respir J"},{"key":"2026012113205008400_ehf214556-bib-0004","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1056\/NEJMoa1506459","article-title":"Adaptive servo-ventilation for central sleep apnea in systolic heart failure","volume":"373","author":"Cowie","year":"2015","journal-title":"N Engl J Med"},{"key":"2026012113205008400_ehf214556-bib-0005","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1093\/eurheartj\/ehv624","article-title":"Nocturnal hypoxaemia is associated with increased mortality in stable heart failure patients","volume":"37","author":"Oldenburg","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012113205008400_ehf214556-bib-0006","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.ijcard.2018.04.076","article-title":"Assessment and interpretation of sleep disordered breathing severity in cardiology: Clinical implications and perspectives","volume":"271","author":"Linz","year":"2018","journal-title":"Int J Cardiol"},{"key":"2026012113205008400_ehf214556-bib-0007","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1164\/rccm.200712-1884OC","article-title":"Sleep-disordered breathing and cardiovascular disease: An outcome-based definition of hypopneas","volume":"177","author":"Punjabi","year":"2008","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012113205008400_ehf214556-bib-0008","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1093\/eurheartj\/ehy624","article-title":"The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: The Osteoporotic Fractures in Men Study and the Sleep Heart Health Study","volume":"40","author":"Azarbarzin","year":"2019","journal-title":"Eur Heart J"},{"key":"2026012113205008400_ehf214556-bib-0009","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1093\/eurheartj\/ehy838","article-title":"Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men","volume":"41","author":"Baumert","year":"2020","journal-title":"Eur Heart J"},{"key":"2026012113205008400_ehf214556-bib-0010","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.sleep.2021.01.007","article-title":"Nocturnal hypoxemic burden during positive airway pressure treatment across different central sleep apnea etiologies","volume":"79","author":"Linz","year":"2021","journal-title":"Sleep Med"},{"key":"2026012113205008400_ehf214556-bib-0011","volume-title":"In: Respironics Inc. (USA)","author":"Respironics Inc. (USA)"},{"key":"2026012113205008400_ehf214556-bib-0012","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1183\/09031936.00083312","article-title":"Auto-servoventilation in heart failure with sleep apnoea: A randomised controlled trial","volume":"42","author":"Arzt","year":"2013","journal-title":"Eur Respir J"},{"key":"2026012113205008400_ehf214556-bib-0013","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.13749","article-title":"Early identification of heart failure deterioration through respiratory monitoring with adaptive servo-ventilation","volume":"32","author":"Fox","year":"2023","journal-title":"J Sleep Res"},{"key":"2026012113205008400_ehf214556-bib-0014","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1007\/s12265-020-10061-0","article-title":"Improving nocturnal hypoxemic burden with transvenous phrenic nerve stimulation for the treatment of central sleep apnea","volume":"14","author":"Oldenburg","year":"2021","journal-title":"J Cardiovasc Transl Res"},{"key":"2026012113205008400_ehf214556-bib-0015","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.ijcard.2023.02.041","article-title":"Transvenous phrenic nerve stimulation for the treatment of central sleep apnea reduces episodic hypoxemic burden","volume":"378","author":"Baumert","year":"2023","journal-title":"Int J Cardiol"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/6\/3725\/64699489\/eschf_10_6_3725.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/6\/3725\/64699489\/eschf_10_6_3725.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:25:31Z","timestamp":1769019931000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/10\/6\/3725\/8284361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,4]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,10,4]]},"published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14556","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12]]},"published":{"date-parts":[[2023,10,4]]},"assertion":[{"value":"2023-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}