Low leptin concentration may identify heart failure patients with central sleep apnea

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In heart failure (HF) patients, sleep‐disordered breathing is highly prevalent (Arzt et al., 2016), and associated with nocturnal hypoxaemia, an independent predictor of mortality (Oldenburg et al., 2016). Central sleep apnea (CSA), a form of sleep‐disordered breathing, is frequent (up to 40% in case series) and has been shown to be related to increased mortality (Arzt et al., 2016) and hospital readmission rates (Khayat et al., 2012). Although therapy is available (Arzt et al., 2007), there is a need for improved screening strategies to identify patients most appropriate for referral for definitive diagnosis by polysomnography (PSG).
Biomarkers that screen effectively for CSA would be useful, as the tools available are either not sufficiently sensitive or specific (Sériès et al., 2005). Recently, both brain (BNP) and atrial natriuretic peptide (Calvin et al., 2011) and leptin (Cundrle et al., 2014) were shown to be associated with increased likelihood of CSA. Natriuretic peptides are elevated in HF patients with CSA and have been proposed as a potential screening tool, although in a small and highly selected cohort (Calvin et al., 2011). Leptin concentration has been shown to be low and correlated inversely with ventilatory drive in HF patients with CSA (Cundrle et al., 2014). However, whether leptin concentrations may be useful for identification of patients with CSA is not known.
We hypothesized that in HF patients low leptin concentrations predicts CSA. Accordingly, the aim of this study was to evaluate leptin concentrations in HF patients with and without CSA, as demonstrated by complete overnight PSG.

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