Impact of CPAP treatment on cardiac biomarkers and pro-BNP in obstructive sleep apnea syndrome

Çifçi, Nilüfer; Uyar, Meral; Elbek, Osman; Süyür, Hüseyin; Erdem, Emine

doi:10.1007/s11325-009-0306-y

Cited by 36 publications

(19 citation statements)

References 22 publications

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“…At 3, 6, and 12 months of follow-up, there was no significant change in NT-pro-BNP levels compared with baseline. In agreement with these data, Cifçi et al (20) did not detect any significant difference in the levels of pro-BNP after 6 months of CPAP therapy. Only patients with moderate or severe OSAHS were included and none had congestive heart failure.…”

Section: Discussionsupporting

confidence: 72%

“…In multiple regression analysis, NT-pro-BNP was significantly correlated with left ventricular ejection fraction, creatinine clearance, and the presence of arterial hypertension but not with AHI. Likewise, Cifçi et al (20) evaluated 33 patients with OSAHS and did not find statistically significant increases in the levels of serum BNP. Consequently, they concluded that OSAHS does not induce enough myocardial damage to increase serum BNP levels.…”

Section: Discussionmentioning

confidence: 95%

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How does serum brain natriuretic peptide level change under nasal continuous positive airway pressure in obstructive sleep apnea-hypopnea syndrome?

Msaad

Marrakchi

Grati

et al. 2016

Libyan Journal of Medicine

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BackgroundObstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with cardiovascular morbidity and mortality, which can be improved by using continuous positive airway pressure (CPAP) therapy. However, the pathophysiological links between the two kinds of disease and the mechanism of the CPAP effect remain incompletely understood. We aimed to inquire into the myocardial involvement in this relationship. We suggested that serum brain natriuretic peptide (BNP) is sensitive enough to detect myocardial stress caused by OSAHS.Design and methodsSixty-four subjects without cardiovascular disease (21 controls, 24 normotensive OSAHS patients, and 19 hypertensive OSAHS patients) were analyzed for serum BNP at baseline and serially over 6 months. CPAP was applied to 23 patients with severe OSAHS.ResultsAt baseline, the serum BNP levels were significantly higher (p=0.0001) in the OSAHS group (22.3±14.79 pg/ml) than in the control group (9.2±6.75 pg/ml). Increased serum BNP levels were significantly associated with mean transcutaneous oxygen saturation (SpO2) (p<0.0001), minimal SpO2 (p=0.002), oxygen desaturation index (p=0.001), and total sleep time spent with SpO2 lower than 90% (p=0.002). All patients with elevated BNP levels (≥37 pg/ml) had moderate or severe OSAHS (11/43 OSAHS patients). The more severe the OSAHS, the higher the BNP levels were. However, only the difference between severe and mild OSAHS was statistically significant (p=0.029). Hypertensive OSAHS patients had the highest baseline BNP levels (27.7±16.74 pg/ml). They were significantly higher (p=0.001) than in normotensive OSAHS patients (18±11.72 pg/ml) (p=0.039) and the controls (9.2±6.75 pg/ml). As compared with baseline, treatment with CPAP significantly decreased BNP levels in both hypertensive and normotensive OSAHS patients (respectively, from 36±16.10 to 29.7±14.29 pg/ml, p<0.001, and from 20±10.09 to 16±8.98 pg/ml, p<0.001). In contrast, the BNP levels slightly increased in the controls (from 9.2±6.75 to 9.5±7.02 pg/ml, p=0.029), but there was no statistically significant difference in comparison with the baseline value. The effect of CPAP on BNP levels was more marked in patients with higher baseline BNP levels and those with the most prolonged nocturnal desaturation (p=0.001, r=0.65). It was also more marked in hypertensive OSHAS patients (p=0.015, r=0.72) in comparison with normotensive OSAHS patients (p=0.03, r=0.62).ConclusionBNP seems to be sensitive enough to detect myocardial stress caused by OSAHS. As such, it is a potential marker for screening of preclinical cardiovascular damage in patients with untreated OSAHS. Application of CPAP decreases levels significantly in normotensive and particularly in hypertensive OSAHS. These findings are consistent with previous results suggesting the potential benefits of CPAP on cardiovascular outcome in OSAHS patients.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 95%

How does serum brain natriuretic peptide level change under nasal continuous positive airway pressure in obstructive sleep apnea-hypopnea syndrome?

Msaad

Marrakchi

Grati

et al. 2016

Libyan Journal of Medicine

View full text Add to dashboard Cite

show abstract

“…Contrary to other studies, however, they showed that there was no change in NT-proBNP level after CPAP treatment (10,25). Similarly, Çifçi et al failed to establish a correlation between OSAS severity and plasma NT-proBNP levels, and reported that NT-proBNP levels were not altered with CPAP treatment (11). In the light of these few studies with conflicting results, it is still unclear what kind of correlation exists between CPAP treatment and serum BNP levels.…”

Section: Discussionmentioning

confidence: 90%

“…The literature contains various studies evaluating NT-proBNP levels before and after CPAP treatment, but this issue has conflicting results (9)(10)(11). Ischemia-modified albumin (IMA) is formed as a result of the normal human albumin N-terminal region undergoing alteration during ischemia (12).…”

Section: Introductionmentioning

confidence: 99%

Effect Of Nasal Continuous Positive Airway Pressure On Global Right Ventricular Myocardial Performance In Patients With Obstructive Sleep Apnea Syndrome

Öztuna¹,

Gozacan²,

Kırış³

et al. 2012

C73. Sleep Disordered Breathing: Epidemiology and Outcomes

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“…Cifci et al (30) also concluded that OSAS did not induce myocardial damage enough to increase CK, CK-MB and troponin I. Some reports (11,31) showed that patients with SAHS could have more collateral vessels, which may lead to myocardial preconditioning.…”

Section: Discussionmentioning

confidence: 99%

The relationship between apnoea hypopnoea index and Gensini score in patients with acute myocardial infarction undergoing emergency primary percutaneous coronary intervention

Zhu

Wang

et al. 2017

J. Thorac. Dis.

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Background: Sleep apnoea hypopnoea syndrome (SAHS) is characterised by repetitive nocturnal hypoxemia and has a high prevalence among patients with acute myocardial infarction (AMI). But there are few studies on patients with AMI undergoing emergency primary percutaneous coronary intervention (pPCI).In this study, we want to find the prevalence of SAHS among patients with AMI undergoing emergency pPCI and determine whether SAHS would worsen the condition among these people, and especially affect the damage degree of the coronary artery Methods: Over four months, 95 patients admitted for the first time for AMI were observed. All of them had emergency primary PCIs. A total of 86 patients accepted the sleep study and were divided into four groups according to the apnoea hypopnoea index (AHI): SAHS was diagnosed when AHI ≥5/h and was defined as mild for AHI ≥5/h and <15/h, moderate for AHI ≥15/h and <30/h, and severe for AHI ≥30/h. On the contrary, the patients whose AHI <5/h were Non-SAHS. And the characteristics of the patients among these four groups were compared. According to the time of chest pain onset, the number of the patients between SAHS and non-SAHS, and patients' AHI during three intervals of one day were measured and compared;Makers including the sensitivity of serum troponin T (hs-TnT), creatine kinase isoenzyme MB (CK-MB), left ventricular ejection fraction (LVEF), pro-brain-type natriuretic peptide (pro-BNP), Gensini score and collateral vessels between the SAHS and non-SAHS were compared. And the relationships between the AHI of these patients and the markers were analysed. Results: Of the 86 patients studied, 65 had SAHS, representing a SAHS prevalence of 75.58% among patients with AMI undergoing emergency pPCI. There were significant differences in average ages, smoking and arrhythmia (P<0.05) between these four groups. There was no significant difference between AMI patients with or without SAHS regarding the day-night pattern. But there showed significant differences between SAHS and non-SAHS in Gensini score (P<0.05) and pro-BNP (P<0.05). Also, there were positive correlations between AHI and Gensini score (r=0.490, P<0.05) and pro-BNP (r=0.338, P<0.05). Conclusions: Among patients with AMI undergoing emergency pPCI, there is a high prevalence of SAHS.There are also positive correlations between AHI and Gensini score, and pro-BNP. Therefore, guided by the results, should we conduct a routine screening to those patients normally and could we relieve the damage to the coronary artery by curing the SAHS?

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Impact of CPAP treatment on cardiac biomarkers and pro-BNP in obstructive sleep apnea syndrome

Abstract: Obstructive sleep apnea syndrome does not induce myocardial damage enough to increase serum pro-BNP, CK, CK-MB, troponin I, and AST levels. Markers sensitive to ischemia could be preferred to evaluate effect of obstructive sleep apnea syndrome.

Cited by 36 publications

References 22 publications

How does serum brain natriuretic peptide level change under nasal continuous positive airway pressure in obstructive sleep apnea-hypopnea syndrome?

How does serum brain natriuretic peptide level change under nasal continuous positive airway pressure in obstructive sleep apnea-hypopnea syndrome?

Effect Of Nasal Continuous Positive Airway Pressure On Global Right Ventricular Myocardial Performance In Patients With Obstructive Sleep Apnea Syndrome

The relationship between apnoea hypopnoea index and Gensini score in patients with acute myocardial infarction undergoing emergency primary percutaneous coronary intervention

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