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Chronic hypersensitivity pneumonitis — SCE Respiratory MCQ

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HardInterstitial Lung DiseaseChronic hypersensitivity pneumonitisSCE Respiratory

A patient with symptomatic heart failure, LVEF 32% and predominant moderate central sleep apnoea remains symptomatic after optimisation of cardiac treatment. Which sleep-ventilation proposal should be rejected because of a mortality signal?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Adaptive servo-ventilation targeted to normalise the apnoea–hypopnoea index

Explanation lettering: C = shown as B · E = shown as C · B = shown as E

E is correct. The AASM standard recommendation is against adaptive servo-ventilation for central sleep apnoea related to heart failure when LVEF is 45% or lower and sleep-disordered breathing is moderate or severe and predominantly central, because SERVE-HF showed increased cardiovascular mortality. The contraindication does not remove the need to optimise heart failure, verify the phenotype and assess oxygenation or obstructive components. It specifically prevents routine ASV normalisation of the AHI in this reduced-ejection-fraction group.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC4865563/