[The effects of noninvasive positive pressure ventilation treatment on plasma concentration of amino terminal-pro brain natriuretic peptide in congestive heart failure in patients with sleep apnea].
OBJECTIVE
Sleep apnea (SA) exerts adverse effects in patients with congestive heart failure (CHF). Amino terminal-pro brain natriuretic peptide (NT-proBNP) is a useful target of CHF treatment. The purpose of this study was to assess the short-term effect of positive pressure ventilation (PPV) on the plasma concentration of NT-proBNP in patients with both CHF and SA.


METHODS
One hundred and five patients diagnosed with CHF participated in the study. Medical history was recorded, and Doppler echocardiography and overnight polysomnography were performed. Seventy-seven patients were diagnosed as having SA. Patients with CHF and SA were randomly assigned to receive medical therapy alone (12 patients) or with the addition of PPV (14 patients) for 2 - 5 days.


RESULTS
Plasma NT-proBNP concentration was measured in 77 patients with CHF and SA. The plasma level of NT-proBNP was associated with the severity of CHF. Subjects with higher degree of NYHA class showed higher a level of NT-proBNP. After PPV treatment, the apnea-hypopnea index decreased (P < 0.001), the lowest SaO2 increased (P < 0.001), and the plasma concentration of NT-proBNP decreased as compared to the baseline levels (P < 0.05).


CONCLUSIONS
The plasma levels of NT-proBNP could reflect the severity of CHF, and PPV treatment could decrease the plasma NT-proBNP level in patients with CHF and SA.
Zhao
Zhi-hui
ZH
Center for Pulmonary Vascular Disease Diagnosis and Treatment, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China.
Liu
Zhi-hong
ZH
Luo
Qin
Q
Zhang
Jian
J
Xiong
Chang-ming
CM
Ni
Xin-hai
XH
Zhang
Shu
S
Yang
Yue-jin
YJ
Ma
Xiu-ping
XP
D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011175:Positive-Pressure Respiration; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications / Q000628:therapy
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain