Eskafi Mahmoud, Cline Charles, Nilner Maria, Israelsson Bo
Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, 20506, Sweden.
Sleep Breath. 2006 Jun;10(2):90-7. doi: 10.1007/s11325-006-0053-2.
The aim of the present study was to investigate the effect of a mandibular advancement device (MAD) for the treatment of sleep apnea (SA) on plasma brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), and health-related qualify of life (HRQL) in patients with mild to moderate stable congestive heart failure (CHF). Seventeen male patients aged 68.4+/-5.5 with an apnea-hypopnea index (AHI) >or=10 were equipped with an individually fitted MAD. SA was evaluated using a portable respiratory multirecording system before and after the initiation of treatment. Eleven patients completed follow-up and were evaluated after 6 months of treatment. The AHI reduced from 25.4+/-10.3 to 16.5+/-10.0 (p=0.033) compared to baseline and mean plasma BNP levels decreased from 195.8+/-180.5 pg/ml to 148.1+/-139.9pg/ml (p=0.035). SA-related symptoms, e.g., excessive daytime sleepiness, were also reduced (p=0.003). LVEF and HRQL were unchanged. We conclude that SA treatment with a MAD on patients with mild to moderate stable CHF appears to result in the reduction of plasma BNP levels. Further studies to investigate if the observed reduction in BNP concentrations also result in improved prognosis are warranted.
本研究的目的是调查下颌前移装置（MAD）治疗睡眠呼吸暂停（SA）对轻度至中度稳定型充血性心力衰竭（CHF）患者血浆脑钠肽（BNP）、左心室射血分数（LVEF）及健康相关生活质量（HRQL）的影响。17名年龄为68.4±5.5岁、呼吸暂停低通气指数（AHI）≥10的男性患者佩戴了量身定制的MAD。在治疗开始前后，使用便携式呼吸多记录系统评估SA情况。11名患者完成随访，并在治疗6个月后接受评估。与基线相比，AHI从25.4±10.3降至16.5±10.0（p = 0.033），血浆BNP平均水平从195.8±180.5 pg/ml降至148.1±139.9 pg/ml（p = 0.035）。与SA相关的症状，如白天过度嗜睡，也有所减轻（p = 0.003）。LVEF和HRQL未发生变化。我们得出结论，对轻度至中度稳定型CHF患者使用MAD治疗SA似乎可导致血浆BNP水平降低。有必要进行进一步研究，以调查观察到的BNP浓度降低是否也会改善预后。
