Mayo School of Graduate Medical Education, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Eur J Heart Fail. 2010 Apr;12(4):354-9. doi: 10.1093/eurjhf/hfq005.
Central sleep apnoea (CSA) and increased serum erythropoietin (EPO) concentration have each been associated with adverse prognosis in heart failure (HF) patients. The aim of this study was to examine the relationship between nocturnal hypoxaemia due to CSA and the serum EPO concentration in patients with HF.
Heart failure subjects (n = 33) and healthy controls (n = 18) underwent polysomnography (PSG) for diagnosis of CSA and identification and quantification of hypoxaemia. Blood collection for measurement of EPO was performed immediately post-PSG. For the analysis, HF subjects were dichotomized into subgroups defined by the presence or absence of CSA and by HF severity. Multivariate analyses were performed to evaluate the relationships of hypoxaemia and advanced HF to EPO concentration. Mean EPO concentration was 62% higher for HF subjects with CSA than for healthy controls (P = 0.004). The magnitude of nocturnal hypoxaemia was significantly and positively related to EPO concentration (r = 0.45, P = 0.02). Advanced HF was also significantly and positively related to EPO concentration (r = 0.43, P = 0.02). On multivariate analysis, the presence of combined nocturnal hypoxaemia and advanced HF yielded greater correlation to EPO concentration than either factor alone (r = 0.57, P = 0.04 and P = 0.05, respectively). Linear regression demonstrated that the combination of New York Heart Association Class and CSA was strongly associated with EPO concentration (P < 0.0001).
In non-anaemic HF patients, advanced HF and hypoxaemia due to CSA may each be independently associated with increased serum EPO concentration.
中枢性睡眠呼吸暂停（CSA）和血清促红细胞生成素（EPO）浓度增加均与心力衰竭（HF）患者的不良预后相关。本研究旨在探讨 HF 患者 CSA 导致的夜间低氧血症与血清 EPO 浓度之间的关系。
心力衰竭患者（n=33）和健康对照者（n=18）接受多导睡眠图（PSG）检查以诊断 CSA 并确定和量化低氧血症。PSG 后立即采集血液以测量 EPO。为了分析，将 HF 患者分为存在或不存在 CSA 以及 HF 严重程度的亚组。进行多变量分析以评估低氧血症和晚期 HF 与 EPO 浓度的关系。与健康对照组相比，CSA 的 HF 患者的平均 EPO 浓度高 62%（P=0.004）。夜间低氧血症的严重程度与 EPO 浓度呈显著正相关（r=0.45，P=0.02）。晚期 HF 与 EPO 浓度也呈显著正相关（r=0.43，P=0.02）。多变量分析表明，同时存在夜间低氧血症和晚期 HF 与 EPO 浓度的相关性大于任一因素单独存在时（r=0.57，P=0.04 和 P=0.05，分别）。线性回归表明，纽约心脏协会（NYHA）分级和 CSA 的组合与 EPO 浓度密切相关（P<0.0001）。
在非贫血性 HF 患者中，晚期 HF 和 CSA 引起的低氧血症可能各自与血清 EPO 浓度增加独立相关。
