title: Echocardiographic findings and plasma endothelin-1 levels in obese patients with and without obstructive sleep apnea.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) and obesity are increasingly prevalent worldwide. Both promote endothelial dysfunction contributing to systemic and pulmonary hypertension over time. Endothelin-1 (ET-1) plays a pivotal role in the development of pulmonary hypertension (PH). The aim of the present study was to assess the association between plasma ET-1 and echocardiographic findings in obese individuals with and without OSA, as well as in non-obese patients with OSA.
  
  
  METHODS
  Ninety-seven subjects (56 males) were enrolled in the study. All subjects underwent the following tests: venous endothelin-1 levels, pulmonary function testing, and arterial blood gas analysis. All patients except controls underwent transthoracic echocardiography and portable testing for sleep-disordered breathing.
  
  
  RESULTS
  Plasma ET-1 levels were significantly higher in obese patients, both with and without OSA (respectively, n = 30 (mean value, 268.06 ± 49.56 pg/ml) and n = 32 (mean value, 263.12 ± 65.26 pg/ml)), compared with non-obese patients with OSA or to healthy controls (respectively, n = 20 (mean value, 149.8 ± 23.09 pg/ml) and n = 15 (mean value, 152.3 ± 27.64 pg/ml); p < 0.0001). Pulmonary artery pressure (PAPs) in obese patients with OSA were significantly higher than in obese patients without OSA (p < 0.0001), while there was no statistical difference between PAPs of obese patients without OSA, compared with the group of non-obese OSA patients. Plasma ET-1 levels significantly correlated with systolic PAPs in obese patients both with and without OSA (respectively, n = 30, r = 0.385, p = 0.03567; n = 32, r = 0.3497, p = 0.0497).
  
  
  CONCLUSIONS
  Our study suggests that endothelin levels are more strongly associated with weight than the presence of sleep-disordered breathing, but pulmonary artery hypertension is associated with both weight and OSA.
authors.affiliation: Institute of Respiratory Disease, School of Medicine, University of Bari, Piazza G. Cesare 12, 70122, Bari, Italy. pierluigicarratu@yahoo.com.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Carratù
authors.affiliation: Institute of Respiratory Disease, School of Medicine, University of Bari, Piazza G. Cesare 12, 70122, Bari, Italy.
authors.forename: Valentina Anna
authors.initials: VA
authors.lastname: Ventura
authors.affiliation: Section of Respiratory Medicine, Hospital S Maria della Pietà, Casoria, Naples, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Maniscalco
authors.affiliation: Institute of Respiratory Disease, School of Medicine, University of Bari, Piazza G. Cesare 12, 70122, Bari, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Dragonieri
authors.affiliation: Division of Internal Medicine, University of Medicine, Bari, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Berardi
authors.affiliation: Division of Internal Medicine, University of Medicine, Bari, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ria
authors.affiliation: Institute of Respiratory Disease, School of Medicine, University of Bari, Piazza G. Cesare 12, 70122, Bari, Italy.
authors.forename: Vitaliano Nicola
authors.initials: VN
authors.lastname: Quaranta
authors.affiliation: Division of Internal Medicine, University of Medicine, Bari, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Vacca
authors.affiliation: Institute of Cardiovascular Disease, University of Medicine, Bari, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Devito
authors.affiliation: Institute of Cardiovascular Disease, University of Medicine, Bari, Italy.
authors.forename: Marco Matteo
authors.initials: MM
authors.lastname: Ciccone
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY, 40508, USA.
authors.forename: Barbara Anne
authors.initials: BA
authors.lastname: Phillips
authors.affiliation: Institute of Respiratory Disease, School of Medicine, University of Bari, Piazza G. Cesare 12, 70122, Bari, Italy.
authors.forename: Onofrio
authors.initials: O
authors.lastname: Resta
mesh_terms: D000328:Adult; D015897:Comorbidity; D015150:Echocardiography, Doppler; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D017286:Polysomnography; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012016:Reference Values; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D013223:Statistics as Topic
chemical_list: D019332:Endothelin-1
keywords: Echocardiography; Endothelin-1; Obesity; Obstructive Sleep Apnea; Pulmonary hypertension; Systolic pulmonary artery pressure; cPAP