SummaryAdaptive servo-ventilation (ASV) is a recently developed, noninvasive therapeutic tool for the treatment of heart failure (HF). However, prediction of responsiveness to continuous ASV therapy remains uncertain, especially in patients with advanced HF receiving guideline-directed medical therapy. A total of 47 patients with advanced HF (NYHA class IV 74%, inotrope infusion dependent 38%) received continuous ASV therapy at our institute between 2008 and 2014. Of these 47 patients, 12 (26%) were responders, whose left ventricular ejection fraction increased ≥ 5% during the 6-month study period. Shorter HF duration (< 17.2 × 10 2 days) was a significant predictor of responsiveness to ASV therapy by logistic regression analysis and receiver operating characteristics analysis. Patients with shorter HF duration achieved improved HF symptoms, recovery of renal function, and a lower readmission ratio compared with the longer HF duration group during ASV therapy. In conclusion, early ASV introduction may be beneficial to achieve left ventricular reverse remodeling during ASV therapy in patients with advanced HF. (Int Heart J 2016; 57: 198-203)

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Introduction: We recently reported a multi-center, single-arm, phase II study that evaluated the efficacy and safety of autologous skeletal myoblast sheet (TCD-51073) transplantation. The advantage of this procedure over a control group has not yet been analyzed. Hypothesis: TCD-51073 has better clinical outcome compared with background-matched control group. Methods: Seven patients with advanced heart failure due to ischemic etiology (TCD-51073 group, New York Heart Association [NYHA] class III; left ventricular ejection fraction (LVEF) <35%) refractory to optimal medical and coronary revascularization therapy, received TCD-51073 at 3 study centers between 2012 and 2013 with a 2-year follow-up period. As previously reported, 112 patients received cardiac resynchronization therapy (CRT) with follow-up at the University of Tokyo Hospital between 2007 and 2014. Results: Of them, 21 patients were selected for the control group by propensity score matching. No significant difference in baseline variables between the groups was observed. LVEF and NYHA class improved significantly in the TCD-51073 group during the 6-month study period (p<0.05). During the 2-year follow-up, 7 patients (33%) in the CRT group and no patient in the TCD-51073 group died due to cardiac disease or received VAD implantation (p=0.128 by the log-rank test). Conclusions: Transplantation of TCD-51073 is clinically advantageous in facilitating LV reverse remodeling, improving HF symptoms, and preventing cardiac death in patients with ischemic etiology when compared to background-matched patients receiving CRT.