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Advanced heart failure and nocturnal hypoxaemia due to central sleep apnoea are associated with increased serum erythropoietin
Author(s) -
Calvin Andrew D.,
Somers Virend K.,
Steensma David P.,
Rio Perez Jose A.,
Walt Christelle,
FitzGibbon Jennifer M.,
Scott Christopher G.,
Olson Lyle J.
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq005
Subject(s) - medicine , nocturnal , heart failure , erythropoietin , cardiology , hypoxemia , sleep (system call) , computer science , operating system
Aims Central sleep apnoea (CSA) and increased serum erythropoietin (EPO) concentration have each been associated with adverse prognosis in heart failure (HF) patients. The aim of this study was to examine the relationship between nocturnal hypoxaemia due to CSA and the serum EPO concentration in patients with HF. Methods and results Heart failure subjects ( n = 33) and healthy controls ( n = 18) underwent polysomnography (PSG) for diagnosis of CSA and identification and quantification of hypoxaemia. Blood collection for measurement of EPO was performed immediately post‐PSG. For the analysis, HF subjects were dichotomized into subgroups defined by the presence or absence of CSA and by HF severity. Multivariate analyses were performed to evaluate the relationships of hypoxaemia and advanced HF to EPO concentration. Mean EPO concentration was 62% higher for HF subjects with CSA than for healthy controls ( P = 0.004). The magnitude of nocturnal hypoxaemia was significantly and positively related to EPO concentration ( r = 0.45, P = 0.02). Advanced HF was also significantly and positively related to EPO concentration ( r = 0.43, P = 0.02). On multivariate analysis, the presence of combined nocturnal hypoxaemia and advanced HF yielded greater correlation to EPO concentration than either factor alone ( r = 0.57, P = 0.04 and P = 0.05, respectively). Linear regression demonstrated that the combination of New York Heart Association Class and CSA was strongly associated with EPO concentration ( P < 0.0001). Conclusion In non‐anaemic HF patients, advanced HF and hypoxaemia due to CSA may each be independently associated with increased serum EPO concentration.