C-reactive protein is elevated in heart failure patients with central sleep apnea and Cheyne-Stokes respiration
| Autor: | Thomas Fischbach, Olaf Oldenburg, Thomas Bitter, Dieter Horstkotte, Heidi Schmalgemeier |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Central sleep apnea medicine.drug_class Cheyne–Stokes respiration Internal medicine medicine Natriuretic peptide Humans Cheyne-Stokes Respiration Aged Retrospective Studies Heart Failure Ejection fraction biology business.industry C-reactive protein Sleep apnea Middle Aged medicine.disease Sleep Apnea Central respiratory tract diseases Obstructive sleep apnea C-Reactive Protein Heart failure biology.protein Cardiology Female medicine.symptom business |
| Zdroj: | Respiration; international review of thoracic diseases. 87(2) |
| ISSN: | 1423-0356 |
| Popis: | Background: Manifestation of central sleep apnea (CSA) with Cheyne-Stokes respiration is of major prognostic impact in chronic heart failure (CHF). Inflammatory processes have been linked to a progression of cardiovascular diseases, including heart failure. While an association of C-reactive protein (CRP) levels to obstructive sleep apnea has been documented before, there is a lack of information regarding variation of CRP levels in patients with CSA. Objectives: The objective of this study was to investigate a potential association of CRP levels to CSA severity in CHF patients. Methods: High sensitivity CRP levels were analyzed in 966 patients with CHF (BMI 26.3 ± 4.6, New York Heart Association class 2.6 ± 0.5, left ventricular ejection fraction 29.4 ± 7.9%, N-terminal pro-brain natriuretic peptide, NT-proBNP, level 2,209 ± 3,315 pg/ml) without sleep-disordered breathing (SDB; Apnea-Hypopnea Index, AHI, Results: The CRP concentration in CHF patients was 0.550 ± 0.794 mg/dl in patients without SDB (AHI 0-4/h, n = 403) versus 0.488 ± 0.708 mg/dl in patients with mild CSA (AHI 5-14/h, n = 123, p = n.s.) and 0.660 ± 0.963 mg/dl in patients with moderate CSA (AHI 15-29/h, n = 160, p = n.s.). In patients with severe CSA (AHI ≥30/h, n = 280), significantly higher CRP concentrations were documented (0.893 ± 1.384 mg/dl, p < 0.05). Stepwise regression analysis revealed AHI, NT-proBNP and heart rate to be independently associated with elevated CRP levels. Conclusion: Severe CSA in CHF patients is associated with elevated levels of CRP, a systemic marker of inflammation and cardiovascular risk. This might explain in part the negative prognostic impact of CSA in these patients. |
| Databáze: | OpenAIRE |
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