1. Continuous Positive Airway Pressure for Heart Patients with Central Sleep Apnea Presented at American College of Cardiology Scientific Sessions 2005 Presented by Dr. T. Douglas Bradley CANPAP

2. www. Clinical trial results.org Endpoints (mean follow-up 2 years):  Primary: Death or heart transplantation  Secondary: Apnea hypopnea index, quality of life Endpoints (mean follow-up 2 years):  Primary: Death or heart transplantation  Secondary: Apnea hypopnea index, quality of life CANPAP Presented at ACC Scientific Sessions 2005 258 patients age 18-79 with heart failure, ejection fraction < 40%, and central sleep apnea despite optimal medical therapy Randomized. Mean age 63 years. Baseline ejection fraction 24.5% 258 patients age 18-79 with heart failure, ejection fraction < 40%, and central sleep apnea despite optimal medical therapy Randomized. Mean age 63 years. Baseline ejection fraction 24.5% Nocturnal CPAP † Titrated as tolerated to 10 cmH 2 O n=128 Nocturnal CPAP † Titrated as tolerated to 10 cmH 2 O n=128 No CPAP n=130 No CPAP n=130 † CPAP was used an average of 4 hours per day during the trial

3. www. Clinical trial results.org Presented at ACC Scientific Sessions 2005 Primary Endpoint: Death or hospitalization p=0.54 CANPAPCANPAP Average sleep time was 304 minutes in the CPAP group and 308 minutes in the control group. Apnea hypopnea index at baseline was 40 apneas/hourAverage sleep time was 304 minutes in the CPAP group and 308 minutes in the control group. Apnea hypopnea index at baseline was 40 apneas/hour There was no difference in the frequency of death or hospitalization between groups or in the cumulative number of hospitalizations (p=0.83)There was no difference in the frequency of death or hospitalization between groups or in the cumulative number of hospitalizations (p=0.83)

4. www. Clinical trial results.org Presented at ACC Scientific Sessions 2005 Secondary Endpoints in the Nocturnal CPAP group CANPAP: 12 weeks The CPAP group had larger decreases in apnea hypopnea index and norepinephrine than the control groupThe CPAP group had larger decreases in apnea hypopnea index and norepinephrine than the control group Apnea Hypopnea Index P<0.001 Norepinephrine p=0.014

5. www. Clinical trial results.org Presented at ACC Scientific Sessions 2005 Secondary Endpoints in the Nocturnal CPAP group CANPAP: 12 weeks The CPAP group had a higher nocturnal oxygen saturation and ejection fraction than the control groupThe CPAP group had a higher nocturnal oxygen saturation and ejection fraction than the control group There were no differences in quality of life or exercise durationThere were no differences in quality of life or exercise duration Mean nocturnal oxygen saturation P<0.001 Ejection fraction P<0.05

6. www. Clinical trial results.org Among heart failure patients with central sleep apnea, use of continuous positive airway pressure was not associated with reductions in death or need for transplantation by 2 years compared with control patients Despite some beneficial findings in apnea hypopnea index, norepinephrine, oxygen saturation, and ejection fraction, the overall clinical event rate was much lower than expected, prompting early discontinuation of the trail Among heart failure patients with central sleep apnea, use of continuous positive airway pressure was not associated with reductions in death or need for transplantation by 2 years compared with control patients Despite some beneficial findings in apnea hypopnea index, norepinephrine, oxygen saturation, and ejection fraction, the overall clinical event rate was much lower than expected, prompting early discontinuation of the trail Presented at ACC Scientific Sessions 2005 CANPAPCANPAP