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FACE collected real life clinical data and long-term follow-up (FU) in a CHF population with SDB eligible for ASV. We previously identified 6 clinically meaningful clusters using Latent class analysis. We investigate herein whether these clusters may have different morbi-mortality outcomes. Reduced (HFrEF), middle range (HFmrEF) and preserved (HFpEF) CHF classes were included. Eligible SDB were central sleep apnea (CSA), coexistent obstructive central SA not controlled under CPAP and CPAP emergent CSA. ASV was offered to all. Controls were patients who refused ASV at inclusion. Morbi-mortality events were collected for 2 years. Primary endpoint in the time-to event analysis was the first event of death, unplanned hospitalization for worsening HF or cardiac transplant. 503 patients were included in the ITT analysis at 2-year FU. ASV was protective for primary outcome (P = 0.01, Fig. 1 A). Cluster behavior regarding primary outcome was different, the worst prognosis was for HFrEF with CSA (Fig. 1 B). ASV did not benefit in the HFrEF with CSA or OSA clusters (Fig. 1 C) but was protective for 2 clusters: obese HFpEF with CSA and severe hypoxemic patients with OSA (Fig. 1 D). These results align with recent studies that showed no impact on morbi-mortality of ASV in HFrEF but a protective effect in two HFpEF clusters. [ABSTRACT FROM AUTHOR]

Adaptive servo-ventilation (ASV) is a non-invasive ventilation mode for suppressing CSA-CSR. FACE is an observational prospective multicentre cohort study designed to assess the effects of adding ASV (PaceWave™, AutosetCS™; ResMed) to standard care on morbidity and mortality in symptomatic chronic HF patients who have CSA or co-existing central and obstructive sleep-disordered breathing (SDB). To collect real life clinical data and long-term follow-up of all CHF patients grade of severity (reduced (HFrEF), mid-range (HFmrEF) or preserved ejection fraction (HFpEF)) with SDB requesting ASV. Medical history, medications, clinical presentation, sleep study, cardiac function and quality of life were assessed at inclusion. Patients are followed up to 2 years. Inclusion data are presented in median with interquartile range or in % of the sample. 509 CHF pts were included, 72 [64; 79] year old, men (88%) and with a BMI of 28 [25; 32] kg/m2. Patients were HFrEF, HFmrEF and HFpEF, in 31, 20, and 50% respectively and 27% had a cardiac implant. Current or former tobacco and alcohol users were 46 and 14% respectively. Main comorbidities were hypertension (72%), diabetes (37%), COPD (12%), atrial fibrillation (40%). ASV indications were predominant CSA (69%), emergent CSA (6.4%) and coexistent OSA-CSA not controlled on CPAP (25%). Although, SDB was severe with a mean AHI per hour of 41 [31; 55] and a sleep time with SpO2 < 90% (T90) of 33 min [5;101] patients were not sleepy with an ESS of 7 [4; 11]. HF symptoms were highly present with a Minnesota Living With Heart Failure Questionnaire (MLHFQ) score of 29 [16; 48] and pts distribution of 19, 43, 33 and 5% in NYHA class I, II, III and IV respectively. SDB were widespread distributed in a heterogeneous population of CHF patients with different etiologies, comorbidities and HF severity classes. A cluster analysis has been conducted to identify different phenogroups. [ABSTRACT FROM AUTHOR]

Adaptive servo-ventilation (ASV) is a non-invasive ventilation mode for suppressing CSA-CSR. FACE is an observational prospective multicentre cohort study designed to assess the effects of adding ASV (PaceWave™, AutosetCS™; ResMed) to standard care on morbidity and mortality in symptomatic chronic HF patients who have CSA or co-existing central and obstructive sleep-disordered breathing (SDB). FACE cohort study was collecting real life clinical data and long-term follow-up in a heterogeneous CHF population with SDB eligible for ASV. Latent class analysis (LCA) was proposed to cluster homogeneous phenogroups that may behaved differently. Clinical presentation, sleep study, cardiac function and quality of life were assessed at inclusion. Patients were on CHF therapy and were offered to be treated by ASV. Morbidity and mortality were collected at 3-month follow-up. The primary end point in the time-to event analysis was the first event of death from any cause, unplanned hospitalization for worsening heart failure or cardiac transplant. 509 CHF pts were included in the ITT analysis, LCA identified 6 well defined phenogroups. At 3-month follow-up, there was significant difference between clusters for primary outcome incidence P < 0.01, and death from any cause or hospitalization for all causes (P < 0.01) and hospitalizations for all causes (P < 0.02). The worse prognosis occurred in the cluster 1 low LVEF < 35%, male (96%), predominant CSA (90%), stroke (38%), Afib (44%), ASV acceptance (53%) (Fig. 1). A phenogroup analysis including cardiac functions, SDB and ASV acceptance is promising in predicting outcomes of CHF patients. [ABSTRACT FROM AUTHOR]