Abstract 11235: Sleep-Disordered Breathing Exacerbates Ongoing Myocardial Damage in Patients With Heart Failure
Background: Sleep-disordered breathing (SDB) has a critical association with mortality and morbidity of patients with heart failure (HF). Troponin T is a maker of ongoing myocardial damages and predicts adverse clinical outcome in patients with HF. Carnitine plays an important role in the utilization of fatty acids and glucose in the myocardium. It has been reported that myocardial carnitine level decreases in the failing heart. We hypothesized that plasma levels of troponin T and carnitine are increased due to the leakage from damaged cardiomyocytes in HF patients with SDB. Therefore, we examined the relation of plasma troponin T and carnitine levels with severity of SDB in HF.
Methods and Results: We performed portable sleep monitor to assess apnea-hypopnea index (AHI), and measured plasma levels of high-sensitive troponin T and carnitine in 131 HF patients. These patients were divided into the three groups based on AHI: group A (None-mild SDB: AHI<15 /h, n=45), group B (Moderate SDB: 15≤AHI<30 /h, n=32) and group C (Severe SDB: AHI≥30 /h, n=54). Levels of high-sensitive troponin T were significantly higher in group C than in groups A and B (group A: 0.018 ± 0.004, group B: 0.024 ± 0.00.5, and group C: 0.057 ± 0.016 ng/ml, P<0.01 vs. group A and P<0.05 vs. group B, respectively). Levels of plasma total carnitine was significantly higher in group C than in groups A and B (group A: 61.0 ± 15.1, group B: 65.0 ± 13.5, and group C: 73.3 ± 17.5 μmol/l, P<0.01 vs. group A and P<0.05 vs. group B, respectively). Furthermore, in the multiple regression analysis, the independent factors to determine plasma levels of high-sensitive troponin T were high-sensitive C-reactive protein (β coefficient 0.461, P<0.01) and AHI (β coefficient 0.239, P=0.025). The independent factors to determine plasma levels of carnitine were estimated glomerular filtration rate (β coefficient -0.205, P<0.01) and AHI (β coefficient 0.236, P=0.02).
Conclusions: The present study indicated that SDB is associated with latent myocardial damage presented by higher plasma levels of troponin T and carnitine in HF patients.
- © 2013 by American Heart Association, Inc.