Sleep apnea is associated with subclinical myocardial injury

October 25, 2013

Obstructive sleep apnea is known to be associated with an increased incidence of cardiovascular disease. Now a new study indicates that OSA is associated with subclinical myocardial injury, as indicated by increased high sensitivity troponin T (hs-TnT) levels. Elevated hs-TnT levels are predictive of both coronary heart disease (CHD) and heart failure (HF) in the general population. This is the first study to demonstrate an independent association between sleep apnea severity and this marker of early myocardial injury.

"Although OSA is associated with increased cardiovascular risk, a causal association has been hard to establish because of the association of OSA with other risk factors," said researcher Amil M. Shah, MD, MPH, of the Brigham and Women's Hospital in Boston. "In our study, we were able to demonstrate that greater OSA severity is independently associated with higher hs-TnT levels, suggesting a role for subclinical myocardial injury in the relationship between OSA and heart failure."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

The study included 1,645 middle-aged and older participants in both the Atherosclerosis Risk in Communities and the Sleep Health Study who were free of CHD and HF at baseline. All subjects underwent overnight home polysomnography. Median follow-up was 12.4 years. OSA severity was categorized as none, mild, moderate, or severe using the respiratory disturbance index.

Hs-TnT levels, but not N terminal pro B-type natriuretic peptide levels (a marker for increased ventricular wall stress), were significantly associated with OSA after adjustment for 17 potential confounders (p=0.02), including age, gender, body mass index, smoking status, hypertension, diabetes, alcohol intake, pulmonary function variables (FEV1 and FVC), COPD status, systolic blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, insulin level and estimated glomerular filtration rate (eGFR). In all OSA severity categories, hs-TnT was significantly related to the risk of death or incident , and this relationship was strongest in the severe OSA group.

Limitations of the study include its cross-sectional design, which precludes conclusions on causality, and a limited number of participants with severe OSA.

"Our results suggest a relationship between subclinical myocardial injury and the increased seen in patients with OSA," said Dr. Shah. "Monitoring of hs-TnT levels in these patients may have prognostic value, particularly in patients with severe OSA."

Explore further: Obstructive sleep apnea is associated with diabetic peripheral neuropathy

Related Stories

OSA increases cardiovascular mortality in the elderly

September 7, 2012

Untreated severe obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular mortality in the elderly, and adequate treatment with continuous positive airway pressure (CPAP) may significantly reduce ...

Treat snoring to avoid deadly heart failure

December 5, 2012

Patients with obstructive sleep apnea have the same early cardiovascular damage as diabetics, according to research presented at EUROECHO and other Imaging Modalities 2012. The study1 was presented by Dr Raluca Mincu from ...

Recommended for you

After watching disturbing video, CPAP usage soars

September 25, 2014

Like more than 20 million other Americans, John Brugger has been diagnosed with sleep apnea. He snored, tossed and turned and struggled to breathe during the night, which often left him not only exhausted the next day but ...

Bad sleep around full moon is no longer a myth

July 25, 2013

Many people complain about poor sleep around full moon. Scientists at the University of Basel in Switzerland now report evidence that lunar cycles and human sleep behavior are in fact connected. The results have been published ...

Interrupted sleep impairs memory in mice

July 25, 2011

With the novel use of a technique that uses light to control brain cells, Stanford University researchers have shown that fragmented sleep causes memory impairment in mice.

Learn that tune while fast asleep

June 24, 2012

Want to nail that tune that you've practiced and practiced? Maybe you should take a nap with the same melody playing during your sleep, new provocative Northwestern University research suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.