Obstructive sleep apnea: Plasma endothelin-1 precursor but not endothelin-1 levels are elevated and decline with nasal continuous positive airway pressure.
Assessment of plasma endothelin-1 (ET-1) reveals conflicting results in cerebral and noncerebral conditions. Obstructive sleep apnea (OSA) syndrome has been used as a definite challenge for the investigation of endothelin measurements. Despite marked sleep-related breathing disturbances in untreated patients peripherally measurable ET-1 concentrations remained within the normal range and did not change after an appropriate therapy with continuous positive airway pressure (CPAP). In contrast, its precursor, big ET-1, was considerably elevated in untreated patients and dropped to normal values after long-term CPAP depending on compliance. Relatively stable big ET-1 elevations in untreated patients, during sleep and wakefulness, suggest that a general endothelial alteration beyond that explained by a direct impact of nocturnal breathing disturbances on the vascular system occurs. CPAP-therapy effectively lowered plasma big ET-1 in compliant patients and thus possibly their related risk for vascular diseases. Big ET-1 has been demonstrated to be a more appropriate marker of endothelial alteration than ET-1 because of its longer half-life. Simultaneous measurements are to be recommended.
Jordan
Wolfgang
W
Department of Psychiatry and Psychotherapy, University of Goettingen, Klinik für Psychiatrie und Psychotherapie, von Sieboldstr. 5, 37075 Goettingen, Germany. wjordan@gwdg.de
Reinbacher
Alexander
A
Cohrs
Stefan
S
Grunewald
Rolf W
RW
Mayer
Geert
G
Rüther
Eckart
E
Rodenbeck
Andrea
A
D000328:Adult; D000368:Aged; D001158:Arteries / Q000378:metabolism; D045422:Continuous Positive Airway Pressure; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010349:Patient Compliance; D011498:Protein Precursors / Q000097:blood*; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D013995:Time
D019332:Endothelin-1; D011498:Protein Precursors; D010100:Oxygen