{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:33:18Z","timestamp":1791232398492,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2007,6,26]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    In the main analysis of the Canadian Continuous Positive Airway Pressure (CPAP) for Patients with Central Sleep Apnea (CSA) and Heart Failure Trial (CANPAP), CPAP had no effect on heart transplant\u2013free survival; however, CPAP only reduced the mean apnea-hypopnea index to 19 events per hour of sleep, which remained above the trial inclusion threshold of 15. This stratified analysis of CANPAP tested the hypothesis that suppression of CSA below this threshold by CPAP would improve left ventricular ejection fraction and heart transplant\u2013free survival.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Of the 258 heart failure patients with CSA in CANPAP, 110 of the 130 randomized to the control group and 100 of the 128 randomized to CPAP had sleep studies 3 months later. CPAP patients were divided post hoc into those whose apnea-hypopnea index was or was not reduced below 15 at this time (CPAP-CSA suppressed, n=57, and CPAP-CSA unsuppressed, n=43, respectively). Their changes in left ventricular ejection fraction and heart transplant\u2013free survival were compared with those in the control group. Despite similar CPAP pressure and hours of use in the 2 groups, CPAP-CSA\u2013suppressed subjects experienced a greater increase in left ventricular ejection fraction at 3 months (\n                    <jats:italic>P<\/jats:italic>\n                    =0.001) and significantly better transplant-free survival (hazard ratio [95% confidence interval] 0.371 [0.142 to 0.967],\n                    <jats:italic>P<\/jats:italic>\n                    =0.043) than control subjects, whereas the CPAP-CSA\u2013unsuppressed group did not (for left ventricular ejection fraction,\n                    <jats:italic>P<\/jats:italic>\n                    =0.984, and for transplant-free survival, hazard ratio 1.463 [95% confidence interval 0.751 to 2.850],\n                    <jats:italic>P<\/jats:italic>\n                    =0.260).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    These results suggest that in heart failure patients, CPAP might improve both left ventricular ejection fraction and heart transplant\u2013free survival if CSA is suppressed soon after its initiation.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.106.683482","type":"journal-article","created":{"date-parts":[[2007,6,11]],"date-time":"2007-06-11T22:33:10Z","timestamp":1181601190000},"page":"3173-3180","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":598,"title":["Suppression of Central Sleep Apnea by Continuous Positive Airway Pressure and Transplant-Free Survival in Heart Failure"],"prefix":"10.1161","volume":"115","author":[{"given":"Michael","family":"Arzt","sequence":"first","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Floras","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Logan","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. John","family":"Kimoff","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Series","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Morrison","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Ferguson","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Belenkie","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Fleetham","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hanly","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Smilovitch","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clodagh","family":"Ryan","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Douglas","family":"Bradley","sequence":"additional","affiliation":[{"name":"From the University of Toronto (M.A., J.S.F., A.G.L., P.H., C.R., G.T., T.D.B.), Toronto, Ontario, Canada; University of British Columbia (J.F.), Vancouver, British Columbia, Canada; University of Calgary (I.B., P.H.), Calgary, Alberta, Canada; University of Western Ontario (K.F.), London, Ontario, Canada; McGill University (R.J.K., M.S.), Montreal, Quebec, Canada; Laval University (F.S.), Quebec City, Quebec, Canada; Dalhousie University (D.M.), Halifax, Nova Scotia, Canada; and the University of..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.7.1337"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200208-793OC"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.2.7633695"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.11.1435"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.1.61"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200511-1745PP"},{"key":"e_1_3_2_7_2","first-page":"677","volume":"17","year":"2001","unstructured":"Bradley TD, Logan AG, Floras JS. 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