The Effect of Obstructive Sleep Apnea Syndrome on Left Ventricular Function,NT-proBNP,ET-1,GDF-15 in Patients with Acute Myocardial Infarction
Objective:To investigate the effect of obstructive sleep apnea syndrome(OSAS)on left ventricular function,N-termi-nal pro-B-type natriuretic peptide(NT-proBNP),endothelin-1(ET-1),and growth differentiation factor-15(GDF-15)in patients with acute myocardial infarction(AMI).Methods:136 AMI patients who underwent emergency PCI at our hospital from March 2020 to June 2022 were selected and divided into non OSAHS group(48 cases),mild OSAHS group(31 cases),moderate OSAHS group(29 cases),and severe OSAHS group(28 cases)based on the apnea hypopnea index(AHI)level.Left ventricular function indicators[left ventricular fractional shortening shortening(LVFS),left ventricular ejection fraction(LVEF)]were examined by echocardiography,and the levels of NT-proBNP,ET-1,GDF-15,creatine kinase(CK),creatine kinase isoenzyme MB(CK-MB),lactate dehydrogenase(LDH),and α-Hy-droxybutyrate dehydrogenase(α-HBDH)were measured.Pearson correlation analysis was used to investigate the correlation between LVFS,LVEF,NT-proBNP,ET-1,GDF-15,and AHI;Multiple logistic regression analysis was used to analyze the risk factors of AMI with OSAHS.Results:(1)Comparison of LVFS and LVEF,the severe OSAHS group＜moderate OSAHS group＜mild OSAHS group＜non OSAHS group(P＜0.05);(2)Comparison of NT-proBNP,ET-1,and GDF-15 levels,the severe OSAHS group＞moderate OSAHS group＞mild OSAHS group＞non OSAHS group(P＜0.05);(3)Comparison of CK,CK-MB,LDH,and α-HBDH levels,the severe OSAHS group＞moderate OSAHS group＞mild OSAHS group＞non OSAHS group(P＜0.05).(4)Pearson correlation analysis showed that:the LVFS,LVEF were negatively correlated with AHI(r=-0.632,-0.573,P＜0.05),while NT-proBNP,ET-1,GDF-15 levels were positively correlated with AHI(r=0.596,0.542,0.517,P＜0.05).(5)Logistic regression analysis shows that:LVFS(OR=6.379,95％CI:3.215～9.543),LVEF(OR=3.016,95％ CI:1.364～4.668),NT-proBNP(OR=5.171,95％ CI:2.316～8.025),ET-1(OR=2.751,95％ CI:1.334～4.168),GDF-15(OR=2.447,95％ CI:1.143～3.752),CK(OR=4.108,95％ CI:1.615～6.602),CK-MB(OR=4.500,95％ CI:1.860～7.139),and LDH(OR=3.435,95％ CI:1.407～5.463)were independent risk factor for AMI with OSAHS(P＜0.05).Conclusions:As the condition of OSAHS progresses,it may worsen left ventricular function,vascular endothelial function,and myocardial damage in AMI patients.The levels of NT proBNP,ET-1,and GDF-15 were increased may be risk factors for AMI with OSAHS.
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