Ferreira JP, Duarte K, Woehrle H, et al. - In the Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnoea by Adaptive Servo Ventilation in Patients with Heart Failure (SERVE-HF) trial, the effects of adaptive servo-ventilation (ASV) vs control on outcomes of 1,325 patients with heart failure and reduced ejection fraction (HFrEF) and central sleep apnoea (CSA) were investigated. Although the two groups did not differ in a composite of all-cause death or unplanned HF hospitalization, the ASV group exhibited higher all-cause and cardiovascular (CV) mortality. In the present study, for the first time, a large set of circulating biomarkers was applied in patients with both HFrEF and CSA considering the possible value of circulating biomarkers in better ascertaining patients' risk. In 749 (57% of the trial population) patients (biomarker substudy), they studied circulating protein-biomarkers (n = 276) ontologically involved in CV pathways, to determine their correlation with the study outcomes (primary outcome, CV death and all-cause death). Of the 276 studied biomarkers, three [soluble suppression of tumorigenicity 2 (sST2) (for the primary outcome), Notch-3 (for CV and all-cause death), and growth differentiation factor 15 (GDF-15) (for all-cause death)] were identified adding significant prognostic information on top of the best clinical model. They identified sST2 and GDF-15 as well-validated and extensively replicated biomarkers in HF. The higher specificity of the role of Notch-3 for HF patients with sleep-disordered breathing is suggested.