Impact of sleep-disordered breathing and its treatment with ASV on left ventricular structure and function in heart failure
Bibliographic record
Abstract
Introduction: Sleep-disordered breathing (SDB), comprising obstructive and central sleep apnea (OSA and CSA) could contribute to left ventricular (LV) remodeling and systolic dysfunction. This analysis of the ADVENT-HF trial tested the hypothesis that SDB is associated with reversible impairment of LV structure and function in patients with heart failure with reduced ejection fraction (LVEF<45%). Methods: Screening echocardiography and polysomnography were performed in patients with HF. Participants were classified into no-SDB (NSDB: apnea-hypopnea index [AHI] <15); OSA (AHI≥15 and ≥50% events obstructive) and CSA (AHI≥15 and >50% events central) and randomized to control or treatment with peak-flow triggered adaptive servo-ventilation (ASVPF) for SDB. Echocardiography was repeated 6 months later. Results: Subjects with OSA (n=543) had similar LV structure and function as those without SDB (n=56). Those with CSA (n=201) had greater LV mass index (106.6±25.4g/m2 for NSDB, 113.8±32.6 for OSA, and 126.6±38.5 for CSA, P<0.001) and lower LVEF than the other groups (35.0±10.6% for NSDB, 35.0±10.1 for OSA, and 31.0±10.2 for CSA, P<0.001). At follow-up (n=549), ASVPF had no effect on LV structure or function, aside from an increase in stroke volume index (SVI) (−0.7±11.3ml/m2 control; 1.2±10.3 ASVPF group, P=0.045). Conclusion: In this cohort, co-existing OSA appears not to exert adverse effects on LV structure or function. CSA signals more advanced LV remodeling and systolic dysfunction. ASVPF did not improve LV structure or function, aside from augmentation of SVI for the entire cohort.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".