Links between sleep disordered breathing, coronary atherosclerotic burden, and cardiac biomarkers in patients with stable coronary artery disease

被引：24

作者：

Inami, Toru ^{[1
]}

Seino, Yoshihiko ^{[1
]}

Otsuka, Toshiaki ^{[2
]}

Yamamoto, Masanori ^{[1
]}

Kimata, Nakahisa ^{[1
]}

Murakami, Daisuke ^{[1
]}

Takano, Masamichi ^{[1
]}

Ohba, Takayoshi ^{[1
]}

Ibuki, Chikao ^{[1
]}

Mizuno, Kyoichi

机构：

[1] Nippon Med Sch, Hokusoh Hosp, Div Cardiol, Inzai, Chiba 2701694, Japan

[2] Nippon Med Sch, Dept Hyg & Publ Hlth, Inzai, Chiba 2701694, Japan

来源：

JOURNAL OF CARDIOLOGY | 2012年 / 60卷 / 3-4期

关键词：

Sleep disordered breathing; Coronary atherosclerosis; Troponin T; N-terminal pro-B-type natriuretic peptide; Cardiac biomarker; CHRONIC HEART-FAILURE; C-REACTIVE PROTEIN; TROPONIN-T ASSAY; CARDIOVASCULAR-DISEASE; OXYGEN-THERAPY; APNEA SYNDROME; HYPERTENSION; ASSOCIATION; DEFINITION; SEVERITY;

D O I：

10.1016/j.jjcc.2012.03.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Sleep disordered breathing (SDB) is highly prevalent in patients with cardiovascular disease, although it is not clear whether SDB has any link to coronary atherosclerotic burden in patients with stable coronary artery disease (CAD). This study sought to analyze the links between SDB, coronary atherosclerotic burden, and cardiac biomarkers in stable CAD patients. Methods and results: We studied 83 consecutive patients who underwent coronary angiography or scheduled percutaneous coronary intervention. SDB was evaluated by an ambulatory polysomnographic monitoring device. Coronary atherosclerotic burden was evaluated by the Gensini score, and myocardial stress/injury were assessed by measuring plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high sensitivity troponin T (hs-TnT). Patients with an apnea hypopnea index (AHI) >= 15 events/h (n = 32) showed significantly higher Gensini score (35.7 +/- 38.0 vs 20.1 +/- 19.7, p = 0.033) than those with AHI < 15. The higher AHI group showed significantly higher NT-proBNP (275.8 +/- 402.6 pg/ml vs 131.9 +/- 146.3 pg/ml, p = 0.047) and hs-TnT levels (0.011 +/- 0.005 ng/ml vs 0.008 +/- 0.003 ng/ml, p = 0.015). Furthermore it was revealed that AHI significantly correlated with the Gensini score (r = 0.253, p = 0.036), NT-proBNP (r = 0.266, p = 0.027), and hs-TnT (r = 0.274, p = 0.023), and multiple stepwise linear regression analysis revealed that AHI (beta = 0.257, p = 0.029) and history of smoking (beta = 0.244, p = 0.038) were independently correlated with Gensini score among clinical and SDB-related parameters. Conclusions: Severity of SDB has a significant link to the severity of coronary atherosclerotic burden, which also reflected elevated NT-proBNP and hs-TnT as silent myocardial ischemia and minute myocardial injury even in stable CAD patients. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

引用

页码：180 / 186

页数：7

共 35 条

[1]

[Anonymous], 1999, SLEEP, V22, P667

[2] Left ventricular morphology and Systolic function in sleep-disordered breathing - The sleep heart health study [J].

Chami, Hassan A. ;

Devereux, Richard B. ;

Gottdiener, John S. ;

Mehra, Reena ;

Roman, Mary J. ;

Benjamin, Emelia J. ;

Gottlieb, Daniel J. .

CIRCULATION, 2008, 117 (20) :2599-2607

[3] Comparison of brain natriuretic peptide (BNP) and amino-terminal ProBNP for early diagnosis of heart failure [J].

Emdin, Michele ;

Passino, Claudio ;

Prontera, Concetta ;

Fontana, Marianna ;

Poletti, Roberta ;

Gabutti, Alessandra ;

Mammini, Chiara ;

Giannoni, Alberto ;

Zyw, Luc ;

Zucchelli, Giancarlo ;

Clerico, Aldo .

CLINICAL CHEMISTRY, 2007, 53 (07) :1289-1297

[4] Cardiac troponin T in obstructive sleep apnea [J].

Gami, AS ;

Svatikova, A ;

Wolk, R ;

Olson, EJ ;

Duenwald, CJ ;

Jaffe, AS ;

Somers, VK .

CHEST, 2004, 125 (06) :2097-2100

[5] A MORE MEANINGFUL SCORING SYSTEM FOR DETERMINING THE SEVERITY OF CORONARY HEART-DISEASE [J].

GENSINI, GG .

AMERICAN JOURNAL OF CARDIOLOGY, 1983, 51 (03) :606-606

[6] Analytical Validation of a High-Sensitivity Cardiac Troponin T Assay [J].

Giannitsis, Evangelos ;

Kurz, Kerstin ;

Hallermayer, Klaus ;

Jarausch, Jochen ;

Jaffe, Allan S. ;

Katus, Hugo A. .

CLINICAL CHEMISTRY, 2010, 56 (02) :254-261

[7] Obstructive Sleep Apnea Leads to Transient Uncoupling of Coronary Blood Flow and Myocardial Work in Humans [J].

Hamilton, Garun S. ;

Meredith, Ian I. ;

Walker, Adrian M. ;

Solin, Peter .

SLEEP, 2009, 32 (02) :263-270

[8]

Hunt Sharon Ann, 2005, J Am Coll Cardiol, V46, pe1, DOI 10.1016/j.jacc.2005.08.022

[9] Obstructive sleep apnea syndrome and hypertension: ambulatory blood pressure [J].

Kario, Kazuomi .

HYPERTENSION RESEARCH, 2009, 32 (06) :428-432

[10] Change in cardio-ankle vascular index by long-term continuous positive airway pressure therapy for obstructive sleep apnea [J].

Kato, Mitsue ;

Kumagai, Takiko ;

Naito, Ryo ;

Maeno, Ken ;

Kasagi, Satoshi ;

Kawana, Fusae ;

Ishiwata, Sugao ;

Narui, Koji ;

Kasai, Takatoshi .

JOURNAL OF CARDIOLOGY, 2011, 58 (01) :74-82

← 1 2 3 4 →