N-terminal pro-B-type natriuretic peptide and functional capacity in patients with obstructive sleep apnea |
| |
Authors: | Micha T Maeder Peter Ammann Hans Rickli Otto D Schoch Wolfgang Korte Christoph Hürny Jonathan Myers Thomas Münzer |
| |
Institution: | (1) Division of Cardiology, Kantonsspital, St. Gallen, Switzerland;(2) Multidisciplinary Sleep Center and Division of Pulmonary Medicine, Kantonsspital, St. Gallen, Switzerland;(3) Institute for Clinical Chemistry and Hematology, Kantonsspital, St. Gallen, Switzerland;(4) Center of Geriatric Medicine and Rehabilitation, Bürgerspital, St. Gallen, Switzerland;(5) Cardiology Division, Palo Alto Veterans Affairs Medical Center, Stanford University, Palo Alto, CA, USA;(6) Division of Cardiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland |
| |
Abstract: | The obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular abnormalities including left ventricular hypertrophy,
left ventricular diastolic dysfunction, and endothelial dysfunction. The present study evaluated whether N-terminal pro-B-type
natriuretic peptide (NT-proBNP) and peak oxygen consumption (peak VO2), both integral markers of cardiovascular function, are related to OSAS severity. In addition, we tested whether NT-proBNP
levels depend on body composition in OSAS patients, similar to what has been reported in patients without OSAS. Eighty-nine
patients with untreated OSAS underwent NT-proBNP measurement, dual X-ray absorptiometry, and cardiopulmonary exercise testing.
In a representative subgroup (n = 32), transthoracic echocardiography was performed. The severity of OSAS was classified based on apnea–hypopnea index (AHI)
values as mild (AHI 5–15 h−1), moderate (AHI 15–30 h−1), and severe (AHI >30 h−1). OSAS was mild in 19 (21%), moderate in 21 (24%), and severe in 49 (55%) patients. NT-proBNP levels did not differ among
patients with mild 30 (10–57)], moderate 37 (14–55)], and severe 24 (13–49) pg/ml; p = 0.8] OSAS and were not related to body mass index (r = 0.07; p = 0.5), percent lean body mass (r = −0.17; p = 0.1), and percent fat mass (r = 0.18; p = 0.1). Percent predicted peak VO2 was on average normal and did not differ among patients with mild (115 ± 26), moderate (112 ± 23), and severe OSAS (106 ± 29%;
p = 0.4). Body weight-indexed peak VO2 did not differ among patients with mild (31.9 ± 10.3), moderate (32.1 ± 7.9), and severe OSAS (30.0 ± 9.9 ml kg−1 min−1; p = 0.6) either. Lower NT-proBNP (β = −0.2; p = 0.02) was independently but weakly associated with higher body weight-indexed peak VO2. In the echocardiography subgroup, NT-proBNP was not significantly related to left ventricular mass index (r = 0.26; p = 0.2). In conclusion, NT-proBNP and peak VO2 are not related to OSAS severity, and NT-proBNP poorly reflects left ventricular hypertrophy in OSAS. The lack of a relationship
between NT-proBNP and OSAS severity is not due to a significant influence of body composition on NT-proBNP. There is an association
between higher NT-proBNP and lower peak VO2, indicating that NT-proBNP is a marker of cardiorespiratory fitness in patients with OSAS. However, the association is too
weak to be clinically useful. |
| |
Keywords: | Obstructive sleep apnea Natriuretic peptides Body mass index Exercise capacity Left ventricular hypertrophy |
本文献已被 SpringerLink 等数据库收录! |
|