Clinical research in cardiology : official journal of the German Cardiac Society
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Reduced sleep quality is associated with impaired quality of life and increased mortality in patients with heart failure. The aim of this study was to observe changes in sleep fragmentation and sleep quality in patients with heart disease and preserved left ventricular ejection fraction (pEF) treated with adaptive servo-ventilation (ASV) therapy for treatment of emergent central sleep apnea (TECSA) or central sleep apnea (CSA). ⋯ In patients with heart disease and pEF, whose TECSA and CSA were treated with ASV, a significant reduction of AHI and arousal index as well as an increase of N3 and REM sleep was observed. Increase of sleep efficiency was significantly greater in TECSA compared to CSA. Hence, improvements of sleep quality were modestly greater in patients with TECSA compared to those with CSA.
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Patients with ST-segment elevation myocardial infarction (STEMI) and consecutive cardiogenic shock (CS) represent a challenge in clinical practice. Only few 'real-world' data on therapeutic management and outcome exist. ⋯ management of patients with CS changed with a steep decrease of IABP implantations. Mortality of patients with CS decreased over the last 10 years. Especially, performance of successful PCI was associated with a reduction of mortality, indicating the crucial role of early revascularization to improve prognosis in this high-risk cohort of STEMI-patients.