Effects of Continuous Positive Airway Pressure on Serum Inflammatory Factors in Coronary Heart Disease Patients Complicated with Obstructive Sleep Apnea-Hypopnea Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 HU Ke ¹ , JIANG Yan ² , FAN Huijun ² , HE Jingya. ¹

Department of Respiratory Disease, Renmin Hospital of Wuhan University.Wuhan, 430060, China;

Corresponding author：

HU Ke, Email: hukejx@sina.com

Keywords：

Coronary heart disease; Obstructive sleep apnea-hypopnea syndrome; Inflammatory factor; Continuous positive airway pressure

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Objective To investigate the changes and significance of serum inflammatory factors in coronary heart disease ( CHD) patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) , and the treatment effects of continuous positive airway pressure( CPAP) . Methods A total of 76 CHD patients in Renmin Hospital of Wuhan University from October 2007 to October 2008 were enrolled. Polysomnography ( PSG) was performed in these CHD patients to identify if they were complicated by OSAHS. The levels of inflammatory factors including TNF-α, IL-6, high sensitive C-reactive protein ( hs-CRP) in serum were determined in the CHD patients and 23 normal subjects. The CHD patients with moderate-severe OSAHS ( AHI≥15 episodes/hour) were treated by Auto-CPAP for 3 months and all parameters above were measured again. Results There were 41 /76 ( 53. 9% ) of CHD patients had moderate-severe OSAHS and were treated with CPAP. The levels of TNF-α, IL-6 and hs-CRP were significantly higher in the CHD patients than those in the normal controls ( all P lt; 0. 01) , and were significantly higher in moderate-severe OSAHS patients than those in the non-OSAHS CHD patients. Auto-CPAP ventilation significantly decreased the levels of inflammatory factors in the CHD patients with moderate-severe OSAHS. Conclusions An obvious proinflammatory state is detected in CHD patients, and is aggravated with OSAHS. CPAP is a useful treatment for CHD patients with mediate to severe OSAHS.

Citation： HU Ke,JIANG Yan,FAN Huijun,HE Jingya.. Effects of Continuous Positive Airway Pressure on Serum Inflammatory Factors in Coronary Heart Disease Patients Complicated with Obstructive Sleep Apnea-Hypopnea Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(4): 376-379. doi: Copy

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3.	Selmi C, Montano N, Furlan R, et al. Inflammation and oxidative stress in obstructive sleep apnea syndrome. Exp Biol Med, 2007, 232 :1409-1413.
4.	Somers VK,White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/ American College of Cardiology Foundation Scientific Statement from the merican Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research ( National Institutes of Health ) .Circulation, 2008, 118: 1080-1111.
5.	Kokturk O, Ciftci TU, Mollarecep E, et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J, 2005, 46: 801-809.
6.	胡克, 李清泉, 杨炯, 等. 茶碱对稳定期慢性充血性心力衰竭患者睡眠呼吸障碍的作用. 中国呼吸与危重监护杂志, 2004, 3: 372-375.
7.	The Report of an American Academy of Sleep Medicine Task Force.Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in linical research.Sleep, 1999, 22: 667-689.
8.	Kosmala W, Derzhko R, Przewlocka-Kosmala M, et al. Plasma levels of TNF-alpha, IL-6 , and IL-10 and their relationship with left ventricular diastolic function in patients with stable angina pectoris and preserved left ventricular systolic performance. Coron Artery Dis,2008, 19: 375-382.
9.	Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial.Thorax, 2009, 64: 67-73.

1. Wilson PW. Evidence of systemic inflammation and estimation of coronary artery disease risk: a population perspective. Am J Med,2008, 121( 10 Suppl 1) : S15-S20.
2. Zamarron C, García Paz V, Riveiro A. Obstructive sleep apnea syndrome is a systemic disease. Current evidence. Eur J Intern Med,2008, 19: 390-398.
3. Selmi C, Montano N, Furlan R, et al. Inflammation and oxidative stress in obstructive sleep apnea syndrome. Exp Biol Med, 2007, 232 :1409-1413.
4. Somers VK,White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/ American College of Cardiology Foundation Scientific Statement from the merican Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research ( National Institutes of Health ) .Circulation, 2008, 118: 1080-1111.
5. Kokturk O, Ciftci TU, Mollarecep E, et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J, 2005, 46: 801-809.
6. 胡克, 李清泉, 杨炯, 等. 茶碱对稳定期慢性充血性心力衰竭患者睡眠呼吸障碍的作用. 中国呼吸与危重监护杂志, 2004, 3: 372-375.
7. The Report of an American Academy of Sleep Medicine Task Force.Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in linical research.Sleep, 1999, 22: 667-689.
8. Kosmala W, Derzhko R, Przewlocka-Kosmala M, et al. Plasma levels of TNF-alpha, IL-6 , and IL-10 and their relationship with left ventricular diastolic function in patients with stable angina pectoris and preserved left ventricular systolic performance. Coron Artery Dis,2008, 19: 375-382.
9. Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial.Thorax, 2009, 64: 67-73.

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Effects of Continuous Positive Airway Pressure on Serum Inflammatory Factors in Coronary Heart Disease Patients Complicated with Obstructive Sleep Apnea-Hypopnea Syndrome

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