Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Department of Cardiovascular Medicine, Faculty of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
Heart Vessels. 2022 Jun;37(6):994-1002. doi: 10.1007/s00380-021-01998-6. Epub 2021 Nov 30.
Sleep disorders and sleep duration have attracted considerable attention as potential modifiable risk factors for the development and progression of heart failure (HF). However, whether these sleep behaviors could aggravate the underlying cardiac condition remains ambiguous. We evaluated the associations between the levels of plasma B-type natriuretic peptide (BNP) and sleep-disordered breathing (SDB), sleep quality and quantity, or daytime sleepiness in cardiovascular diseases (CVD) patients. A total of 1717 consecutive patients with CVD [median age, 66 years (55-74 years); female, 27.5%] were enrolled. SDB was screened by nocturnal pulse oximetry; sleep quality and quantity were determined by Pittsburg Sleep Quality Index, and daytime sleepiness was examined by Epworth Sleepiness Scale. The median plasma BNP level was 54.9 pg/ml (23.5-146.4 pg/ml). Multiple regression analyses showed that the BNP level in the highest quintile (BNP > 181.8 pg/ml) was associated with SDB (severe: OR, 5.88; 95% CI 3.17-10.88; moderate: OR, 3.62; 95% CI 2.17-6.02; mild: OR, 2.22: 95% CI 1.42-3.47). There were no significant associations between other sleep parameters and higher BNP levels. The relationship between SDB and BNP levels was unchanged regardless of the previous history of symptomatic HF. SDB was independently associated with the elevated plasma BNP level in patients with a variety of CVD.
睡眠障碍和睡眠时间作为心力衰竭（HF）发生和进展的潜在可改变的危险因素引起了相当大的关注。然而，这些睡眠行为是否会加重潜在的心脏状况仍不清楚。我们评估了心血管疾病（CVD）患者的血浆 B 型利钠肽（BNP）水平与睡眠呼吸障碍（SDB）、睡眠质量和数量或日间嗜睡之间的关系。共纳入 1717 例连续 CVD 患者[中位年龄 66 岁（55-74 岁）；女性占 27.5%]。通过夜间脉搏血氧饱和度筛查 SDB；通过匹兹堡睡眠质量指数评估睡眠质量和数量，通过 Epworth 嗜睡量表评估日间嗜睡。血浆 BNP 中位数为 54.9pg/ml（23.5-146.4pg/ml）。多元回归分析显示，BNP 最高五分位（BNP > 181.8pg/ml）与 SDB 相关（重度：OR 5.88；95%CI 3.17-10.88；中度：OR 3.62；95%CI 2.17-6.02；轻度：OR 2.22；95%CI 1.42-3.47）。其他睡眠参数与较高的 BNP 水平之间没有显著关联。无论是否有症状性 HF 的既往病史，SDB 与 BNP 水平之间的关系都没有改变。SDB 与 CVD 患者血浆 BNP 水平升高独立相关。
