Cardiac markers in COPD comorbidity with sleep apnea hypopnea syndrome

The aim of the study was to investigate markers of the functional state of the heart muscle in patients with COPD and comorbid sleep apnea hypopnea syndrome. The materials and methods of the study included 223 patients with COPD verified in accordance with the GOLD recommendations (2019-2022), 100 of whom had comorbidity with OSA. Blood levels of NT-proBN and the cardiac marker troponin(TnT) were determined. The results of the study emphasized that COPD patients with severe OSA have a high frequency of occurrence of the NT-proBNP threshold value of more than 600 ng/l, reflecting the manifestations of chronic heart failure (CHF,) which is almost 4.9 times higher in relation to the cohort of COPD patients and 10 times higher in relation to the cohort of COPD patients with mild OSA (p <0.05). Analysis of the diagnostic ranges of TnT, determining the interval of 0.1–0.3 ng/ml, corresponding to the indicators of myocardial necrosis, was more common among COPD patients with OSA, significantly in severe OSA, where its frequency was 52.6%, which was 2 times higher compared to the cohort of COPD patients without OSAHS and 5 times higher in relation to COPD patients with mild OSA. Conclution. With the worsening severity of OSA in COPD patients, the frequency of clinically significant levels of threshold concentrations of TnT (more than 0.3 ng/ml) increases to 100% and threshold concentrations of NT-proBNP (more than 600 ng/l) - a high probability of CHF risk - from 7.7 to 76.9%, correlating with the severity of desynchronosis of the adaptive mechanisms of the parameters of the cardiovascular system and the risk of fatal catastrophes, as well as an increase in the frequency of "deficiency" of D (less than 12 ng/l), determining the high risks of frequent exacerbations from 29.2-45.8%.

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