Abstract
Objective
To evaluate the effect of continuous positive airway pressure (CPAP) therapy on pro-brain natriuretic peptide (BNP) and cardiac markers in patients with obstructive sleep apnea syndrome and normal cardiac function.
Methods
Thirty-three consecutive patients with sleep apnea syndrome were analysed for serum pro-BNP and cardiac markers prior to and after 6 months of CPAP therapy.
Results
Twenty five patients had normal (83.3%) while remaining five (16.7%) revealed high pro-BNP values. We did not detect any significant difference between severity of obstructive sleep apnea syndrome and serum pro-BNP levels (p = 0.534). A statistically significant difference was not observed between basal and sixth-month creatine kinase (CK), creatine kinase-MB (CK-MB), troponin I, pro-BNP, aspartate transaminase (AST), and CK levels in patients with sleep apnea syndrome (p > 0.05).
Conclusion
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.
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References
Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, Wolf PA, Vasan RS (2004) Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med 350:655–663
Hukins CA (2006) Obstructive sleep apnea—management update. Neuropsychiatr Dis Treat 3:309–326
Goetze JP, Friis-Hansen L, Rehfeld JF, Nilsson B, Svendsen JH (2006) Atrial secretion of B-type natriuretic peptide. Eur Heart J 27:1648–1650
Grabowski M, Filipiak KJ, Karpinski G, Wretowski D, Rdzanek A, Huczek Z, Horszczaruk GJ, Kochman J, Ruduwski R, Opolski G (2004) Serum B-type natriuretic peptide levels on admission predict not only short term death but also angiographic success of procedure in patients with acute ST-elevation myocardial infarction treated with primary angioplasty. Am Heart J 148:655–662
Richards AM, Nicholls MG, Espiner EA, Lainchbury JG, Trouqhton RW, Elliott J, Frampton C, Turner J, Crozier IG, Yandle TG (2003) B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation 107:2786–2792
Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD (2003) Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 348:1233–1241
Anwaruddin S, Januzzi JL Jr, Baggish AL, Lewandrowski EL, Lewandrowski KB (2005) Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting. Am J Clin Pathol 123:140–145
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W (2006) American society of echocardiography's nomenclature and standards committee; task force on chamber quantification; American college of cardiology echocardiography committee; American heart association; European association of echocardiography. European society of cardiology. Recommendations for chamber quantification. Eur J Echocardiog 7:79–108
American Academy of Sleep Medicine (1999) Sleep related breathing disorders in adults: recommendations for syndrome definition techniques in clinical research. The report of an American Academy of Sleep Medicine Task force. Sleep 22:667–689
Butt M, Dwivedi G, Khair O, Lip GY (2009) Obstructive sleep apnea and cardiovascular disease. Int J Cardiol (epub ahead of print)
McNicholas WT, Bonsigore MR, Management Committee of EU COST ACTION B26 (2007) Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 29:156–178
Maeder MT, Ammann P, Rickli H, Schoch OD, Korte W, Hürny C, Myers J, Münzer T (2008) N-terminal pro-B-type natriuretic peptide and functional capacity in patients with obstructive sleep apnea. Sleep Breath 12:7–16
Kaditis AG, Alexopoulos EI, Hatzi F, Kostadima E, Kiaffas M, Zakynthinos E (2006) Overnight change in brain natriuretic peptide levels in children with sleep-disordered breathing. Chest 130:1377–1384
Zhao ZH, Liu ZH, Luo Q, Xiong CM, Ni XH, Zhang J, Zhang S, Yang YJ (2006) Positive pressure ventilation treatment reduces plasma levels of amino terminal-probrain natriuretic peptide in congestive heart failure patients with sleep apnea. Circ J 70:572–574
Kita H, Ohi M, Chin K, Noquchi T, Otsuka N, Tsuboi T, Itoh H, Nakao K, Kuno K (1998) The nocturnal secretion of cardiac natriuretic peptides during obstructive sleep apnoea and its response to therapy with nasal continuous positive airway pressure. J Sleep Res 7:199–207
Hubnera RH, El Mokhtarib NE, Freitag S, Rauscheb T, Goderd R, Tirokeb A (2008) NT-proBNP is not elevated in patients with obstructive sleep apnoea. Respir Med 102:134–142
Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R (2005) N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med 352:666–675
Gami AS, Svatikova A, Wolk R, Olson EJ, Duenwald CJ, Jaffe AS, Somers VK (2004) Cardiac troponin T in obstructive sleep apnea. Chest 125:2097–2100
Acknowledgment
We would like to thank to Meltem Akın and Eda İkbal for statistical evaluation of the study.
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Çifçi, N., Uyar, M., Elbek, O. et al. Impact of CPAP treatment on cardiac biomarkers and pro-BNP in obstructive sleep apnea syndrome. Sleep Breath 14, 241–244 (2010). https://doi.org/10.1007/s11325-009-0306-y
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DOI: https://doi.org/10.1007/s11325-009-0306-y