Relation of natriuretic peptide concentrations to central sleep apnea in patients with heart failure

Andrew D. Calvin, Virend Somers, Christelle Van Der Walt, Christopher G. Scott, Lyle J. Olson

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Central sleep apnea (CSA) is frequent among patients with heart failure (HF) and associated with increased morbidity and mortality. Elevated cardiac filling pressures promote CSA and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) secretion. We hypothesized that circulating natriuretic peptide concentrations predict CSA. Methods:Consecutive patients with HF (n = 44) with left ventricular ejection fraction (LVEF) ≤35% underwent polysomnography for detection of CSA. CSA was defined as an apnea-hypo pnea index ≥ 15 with ≥ 50% central apneic events. The relation of natriuretic peptide concentrations to CSA was evaluated by estimation of ORs and receiver operator characteristics (ROCs). Results:Twenty-seven subjects (61%) had CSA, with men more frequently affected than women (73% vs 27%; OR, 7.1; P =.01); given that only three women had CSA, further analysis was restricted to men. Subjects with CSA had higher mean ANP (4,336 pg/mL vs 2,510 pg/mL, P =.03) and BNP concentrations (746 pg/mL vs 379 pg/mL, P =.05). ANP and BNP concentrations were significantly related to CSA (OR, 3.7 per 3,000 pg/mL, P =.03 and OR, 1.5 per 200 pg/mL, P =.04, respectively), whereas age, LVEF, and New York Heart Association functional class were not. Concentrations of ANP and BNP were predictive of CSA as ROC demonstrated areas under the curve of 0.75 and 0.73, respectively. Conclusions:Risk of CSA is related to severity of HF. ANP and BNP concentrations performed similarly for detection of CSA; low concentrations appear associated with low risk for CSA in men.

Original languageEnglish (US)
Pages (from-to)1517-1523
Number of pages7
JournalChest
Volume140
Issue number6
DOIs
StatePublished - Dec 2011

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Central Sleep Apnea
Natriuretic Peptides
Heart Failure
Brain Natriuretic Peptide
Atrial Natriuretic Factor
Stroke Volume
Polysomnography
Apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Relation of natriuretic peptide concentrations to central sleep apnea in patients with heart failure. / Calvin, Andrew D.; Somers, Virend; Van Der Walt, Christelle; Scott, Christopher G.; Olson, Lyle J.

In: Chest, Vol. 140, No. 6, 12.2011, p. 1517-1523.

Research output: Contribution to journalArticle

Calvin, Andrew D. ; Somers, Virend ; Van Der Walt, Christelle ; Scott, Christopher G. ; Olson, Lyle J. / Relation of natriuretic peptide concentrations to central sleep apnea in patients with heart failure. In: Chest. 2011 ; Vol. 140, No. 6. pp. 1517-1523.
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abstract = "Background: Central sleep apnea (CSA) is frequent among patients with heart failure (HF) and associated with increased morbidity and mortality. Elevated cardiac filling pressures promote CSA and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) secretion. We hypothesized that circulating natriuretic peptide concentrations predict CSA. Methods:Consecutive patients with HF (n = 44) with left ventricular ejection fraction (LVEF) ≤35{\%} underwent polysomnography for detection of CSA. CSA was defined as an apnea-hypo pnea index ≥ 15 with ≥ 50{\%} central apneic events. The relation of natriuretic peptide concentrations to CSA was evaluated by estimation of ORs and receiver operator characteristics (ROCs). Results:Twenty-seven subjects (61{\%}) had CSA, with men more frequently affected than women (73{\%} vs 27{\%}; OR, 7.1; P =.01); given that only three women had CSA, further analysis was restricted to men. Subjects with CSA had higher mean ANP (4,336 pg/mL vs 2,510 pg/mL, P =.03) and BNP concentrations (746 pg/mL vs 379 pg/mL, P =.05). ANP and BNP concentrations were significantly related to CSA (OR, 3.7 per 3,000 pg/mL, P =.03 and OR, 1.5 per 200 pg/mL, P =.04, respectively), whereas age, LVEF, and New York Heart Association functional class were not. Concentrations of ANP and BNP were predictive of CSA as ROC demonstrated areas under the curve of 0.75 and 0.73, respectively. Conclusions:Risk of CSA is related to severity of HF. ANP and BNP concentrations performed similarly for detection of CSA; low concentrations appear associated with low risk for CSA in men.",
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AB - Background: Central sleep apnea (CSA) is frequent among patients with heart failure (HF) and associated with increased morbidity and mortality. Elevated cardiac filling pressures promote CSA and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) secretion. We hypothesized that circulating natriuretic peptide concentrations predict CSA. Methods:Consecutive patients with HF (n = 44) with left ventricular ejection fraction (LVEF) ≤35% underwent polysomnography for detection of CSA. CSA was defined as an apnea-hypo pnea index ≥ 15 with ≥ 50% central apneic events. The relation of natriuretic peptide concentrations to CSA was evaluated by estimation of ORs and receiver operator characteristics (ROCs). Results:Twenty-seven subjects (61%) had CSA, with men more frequently affected than women (73% vs 27%; OR, 7.1; P =.01); given that only three women had CSA, further analysis was restricted to men. Subjects with CSA had higher mean ANP (4,336 pg/mL vs 2,510 pg/mL, P =.03) and BNP concentrations (746 pg/mL vs 379 pg/mL, P =.05). ANP and BNP concentrations were significantly related to CSA (OR, 3.7 per 3,000 pg/mL, P =.03 and OR, 1.5 per 200 pg/mL, P =.04, respectively), whereas age, LVEF, and New York Heart Association functional class were not. Concentrations of ANP and BNP were predictive of CSA as ROC demonstrated areas under the curve of 0.75 and 0.73, respectively. Conclusions:Risk of CSA is related to severity of HF. ANP and BNP concentrations performed similarly for detection of CSA; low concentrations appear associated with low risk for CSA in men.

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