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Relationship between inflammatory biomarkers and sleep-disordered breathing in patients with heart failure
Sleep and Biological Rhythms ( IF 1.0 ) Pub Date : 2020-10-06 , DOI: 10.1007/s41105-020-00287-5
Akihiro Sato , Takao Kato , Takatoshi Kasai , Sayaki Ishiwata , Shoichiro Yatsu , Hiroki Matsumoto , Jun Shitara , Azusa Murata , Megumi Shimizu , Shoko Suda , Yuya Matsue , Ryo Naito , Masaru Hiki , Hiroyuki Daida

Inflammation activation is associated with adverse outcomes in patients with heart failure (HF). Sleep-disordered breathing (SDB) observed in 50% of patients with HF worsens the clinical outcome of HF, possibly through the exacerbation of inflammation. However, data on inflammation activation related to SDB are limited in patients with HF. We investigated the relationship between SDB severity and serum levels of C-reactive protein (CRP) and tumor necrotic factor (TNF)-α in HF patients with systolic dysfunction. Nineteen patients with HF were enrolled (mean age, 67.3 years; 16 men; mean ejection fraction, 33.6%). No significant correlation was observed between log-transformed CRP level and apnea–hypopnea index (AHI). In univariable analysis for serum CRP level, the percentage of rapid eye movement (REM) sleep per total sleep time was the only significant factor. The lower the percentage of REM sleep, the higher was the CRP level (coefficient, − 0.474; P = 0.047). In contrast, the serum TNF-α level was significantly correlated with age, ischemic etiology, diabetes mellitus, estimated glomerular filtration rate (eGFR), and AHI. In multivariable analysis, eGFR (coefficient, − 0.486; P = 0.017) and AHI (coefficient, 0.399; P = 0.044) significantly and independently correlated with TNF-α level. The severity of SDB expressed as AHI was directly related to the circulating level of TNF-α, but not circulating CRP level, in HF patients with systolic dysfunction.

中文翻译:

心力衰竭患者炎症生物标志物与睡眠呼吸障碍的关系

炎症激活与心力衰竭 (HF) 患者的不良结果相关。在 50% 的 HF 患者中观察到的睡眠呼吸障碍 (SDB) 会恶化 HF 的临床结果,这可能是由于炎症的加剧。然而,与 SDB 相关的炎症激活数据在 HF 患者中是有限的。我们研究了收缩功能障碍 HF 患者 SDB 严重程度与血清 C 反应蛋白 (CRP) 和肿瘤坏死因子 (TNF)-α 水平之间的关系。招募了 19 名 HF 患者(平均年龄,67.3 岁;16 名男性;平均射血分数,33.6%)。在对数转换的 CRP 水平和呼吸暂停低通气指数 (AHI) 之间未观察到显着相关性。在血清 CRP 水平的单变量分析中,快速眼动 (REM) 睡眠占总睡眠时间的百分比是唯一的重要因素。REM 睡眠百分比越低,CRP 水平越高(系数,- 0.474;P = 0.047)。相反,血清 TNF-α 水平与年龄、缺血性病因、糖尿病、估计肾小球滤过率 (eGFR) 和 AHI 显着相关。在多变量分析中,eGFR(系数,- 0.486;P = 0.017)和 AHI(系数,0.399;P = 0.044)与 TNF-α 水平显着且独立相关。在收缩功能障碍的 HF 患者中,以 AHI 表示的 SDB 的严重程度与 TNF-α 的循环水平直接相关,但与循环 CRP 水平无关。血清 TNF-α 水平与年龄、缺血性病因、糖尿病、估计肾小球滤过率 (eGFR) 和 AHI 显着相关。在多变量分析中,eGFR(系数,- 0.486;P = 0.017)和 AHI(系数,0.399;P = 0.044)与 TNF-α 水平显着且独立相关。在收缩功能障碍的 HF 患者中,以 AHI 表示的 SDB 的严重程度与 TNF-α 的循环水平直接相关,但与循环 CRP 水平无关。血清 TNF-α 水平与年龄、缺血性病因、糖尿病、估计肾小球滤过率 (eGFR) 和 AHI 显着相关。在多变量分析中,eGFR(系数,- 0.486;P = 0.017)和 AHI(系数,0.399;P = 0.044)与 TNF-α 水平显着且独立相关。在收缩功能障碍的 HF 患者中,以 AHI 表示的 SDB 的严重程度与 TNF-α 的循环水平直接相关,但与循环 CRP 水平无关。
更新日期:2020-10-06
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