Objective: The purposes of this study are to: (1) Measure neurohumoral activation in heart failure patients with
and without sleep disordered breathing; (2) Assessment of neurohumoral markers with the severity of sleep apnea and
severity of heart failure.
Patients and methods: In this case report study, we studied 100 patients with heart failure (64 male, 36 female).
All patients underwent echocardiography and a full night-attended polysomnography, in addition to neurohumoral
evaluation.
Results: Group (1) sleep Disordered Breathing (SDB) had significant increase in the plasma concentration level of
BNP (591.50 ± 165.75 vs. 298.33 ± 86.63 pg/ml, P=0.001*), NT-proBNP (1750.05 ± 773.15 vs. 686.98 ± 377.88 pg/ml,
P=0.001*) and nor epinephrine (NE) (616.12 ± 139.57 vs. 203.80 ± 64.30 pg/ml, P=0.001*) when compared with No-SDB.
A significant increase in plasma level of NT-proBNP and nor-epinephrine (NE) in OSA was observed when compared
with central sleep apnea (CSA). Increased neurohumoral markers with different severity of apnea hypopnea index
(AHI). Moreover, a significant increase was observed in neurohumoral markers with increased severity of left ventricular
ejection fraction (LVEF). Based on echocardiographic etiology of heart failure, patients with dilated cardiomyopathy had
a significant increase in plasma level of BNP and NT-pro BNP. On the other hand, plasma concentration level of norepinephrine
(NE) was significantly increased in patients with hypertensive heart disease.
Conclusion: Heart failure patients with sleep disordered breathing were associated with higher levels of
neurohumoral activation. Moreover N-TproBNP (<300m pg/ml) and nor epinephrine (NE)<300 pg/ml were predictors of
OSA among heart failure