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CompletedNCT00976417Updated Dec 7, 2011

Mechanisms of Action of Adaptive Servoventilation

An observational study in Heart Failure and Sleep Apnea Syndromes, sponsored by ResMed. Completed at 1 site in United Kingdom. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2011-12-07.

Sponsored by ResMed · Observational

Study type
Observational
Time perspective
Prospective
Enrollment
50
Ages
18 Years and older
Sex
All
01

Study summary

It is known that a significant proportion of patients with heart failure have sleep disordered breathing (SDB). Some of these patients will have Central Sleep Apnoea which is one form of SDB. The SERVE-HF study aims to look at the effect of a breathing support machine, or ventilator called Adaptive Servo-ventilation (ASV) on mortality in heart failure patients with central sleep apnoea. In this related sub-study the investigators want to look at how the ASV machine has its effect. The investigators will be carrying out tests in the laboratory to measure various aspects of the way that breathing is controlled to measure the effect that ASV has on patients.

In addition measurements looking at activity levels will be made using an actiwatch device worn by patients for 14 consecutive days and nights.

Healthy controls will be recruited to all parts of this protocol (ie measurements at baseline and 3 months) to allow comparison of data between patients and controls.

Read the detailed description

As part of a wider study we are interested in how patients with a failing heart breathe during sleep. It is known that patients with heart failure and central sleep apnoea (a form of breathing difficulty during sleep) have a poorer prognosis. It is likely that this is because this condition places an extra strain on the heart. We want to investigate whether or not treating these breathing problems is of benefit to this group of patients. The proposed study will investigate why a significant proportion of patients with heart failure have central sleep apnoea and how they respond to treatment. We will do this by measuring some of the factors which contribute to how they breathe:

(i) How the brain changes the breathing rate and depth in response to a change in carbon dioxide levels (Chemosensitivity); (ii) How the blood vessels in the brain change in response to a change in carbon dioxide levels (Cerebral Vascular Reactivity); (iii) An overall measure of breathing control called "Loop Gain" (this protocol will only be undertaken in a subgroup of patients who will give specific consent).

These measurements will be carried out in the laboratory in patients taking part in SERVE-HF; a multicentre randomised controlled study of adaptive servoventilation (ASV). ASV is a form of non-invasive ventilation (delivered by a mask worn on the face) shown in previous smaller studies to adequately suppress sleep disordered breathing. The proposed study will allow us to take measurements from patients assigned to both the treatment and control groups; and compare measurements made in both groups at the start of treatment and at three months.

In addition measurements looking at activity levels will be made using an actiwatch device worn by patients for 14 consecutive days and nights. Previously it has been demonstrated that heart failure patients with sleep disordered breathing have lower levels of daytime activity when compared to heart failure patients without sleep disordered breathing. We will investigate the effect of ASV on activity measurements on this patients with sleep disordered breathing.

Healthy controls will be recruited to all parts of this protocol (ie measurements at baseline and 3 months) to allow comparison of data between patients and controls.

02

Conditions studied

  • Heart Failure
  • Sleep Apnea Syndromes
03

In context

Sleep Apnea Syndromes

2,162 studies on the registry are indexed under Sleep Apnea Syndromes; 290 are open to participants now.

This study's planned enrollment of 50 is below the median of 109 across 654 observational studies indexed under Sleep Apnea Syndromes.

Browse Sleep Apnea Syndromes studies →

Lead sponsor

ResMed is the lead sponsor of 105 studies on the registry; 13 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 6 (50%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Patients already recruited to the SERVE-HF study.

Inclusion criteria

  • Over 18 years of age
  • Severe Chronic Heart Failure (CHF) with NYHA class III-IV or NYHA class II with at least one hospitalisation for HF within the last 12 months
  • Left ventricular ejection fraction (LVEF) \<40% by means of echocardiography, radionucleotide angiography, left ventriculography or cardiac MRI documented less than 12 weeks before randomisation
  • Diagnosis of sleep disordered breathing SDB (apnoea-hypopnoea-index (AHI >15/h) with ≥ 50% central events and a central AHI ≥ 10/h)
  • Clinically stable with no change in medication and no hospitalisation in preceding month
  • Optimised medical treatment according to the applicable guidelines
  • Able to provide informed consent

Exclusion criteria

Exclusion Criteria:

  • Significant chronic obstructive pulmonary disease (COPD) with Forced Expiratory Volume within one second (FEV1) \<50%
  • Oxygen saturation at rest during the day ≤ 90% at inclusion
  • Current use of Positive Airway Pressure (PAP) therapy
  • Life expectancy \< 1 year for diseases unrelated to chronic heart failure
  • Cardiac surgery, Percutaneous coronary intervention (PCI), Myocardial Infarction (MI) or unstable angina within 6 months prior to randomisation
  • Implantation of ICD (implanted cardiodefibrillator) or CRT (cardiac resynchronisation therapy) scheduled or within 6 months prior to randomisation
  • Transient ischemic attack (TIA) or Stroke within 3 months prior to randomisation
  • Primary hemodynamically significant uncorrected valvular heart disease, obstructive or regurgitant, or any valvular disease expected to lead to surgery during the trial
  • Acute myocarditis/pericarditis within 6 months prior to randomisation
  • Untreated or therapy refractory Restless legs Syndrome (RLS)
  • Pregnancy
05

Study design

Time perspective
Prospective
Enrollment
50 participants (estimated)
Biospecimen retention
Samples without dna

Groups and cohorts

  • 1. Patients in the control group
  • 2. Patients in the intervention group
06

Study locations

1 site
  • Royal Brompton Hospital and Imperial College
    London, United Kingdom
07

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 7, 2011, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00976417
Lead sponsor
ResMed
Collaborators
Royal Brompton & Harefield NHS Foundation Trust, Imperial College London
Responsible party
Sponsor
First posted
Sep 14, 2009
Start date
Sep 2009
Primary completion
Oct 2011
Completion
Oct 2011
Last update
Dec 7, 2011

Study contacts

Mary Morrell, PhD
principal investigator · Imperial College London

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2011. You cannot join it, but the record below documents what was studied.

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