ВЛИЯНИЕ СИНДРОМА ОБСТРУКТИВНОГО АПНОЭ/ГИПОПНОЭ СНА НА УРОВНИ ТКАНЕВОГО ИНГИБИТОРА МАТРИКСНЫХ МЕТАЛЛОПРОТЕИНАЗ-1 И ИНДУЦИРУЕМОГО ГИПОКСИЕЙ ФАКТОРА-1Α У ПАЦИЕНТОВ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ

Abstract

Bacground. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with increased incidence and progression of atrial fibrillation (AF). Experimental studies indicate that OSAHS can modify the cardiac extracellular matrix (ECM). However, significant mechanisms of cardiac remodeling in AF patients with OSAHS have not been uncovered.The aim: to evaluate the impact of OSAHS on serum levels of tissue inhibitor of matrix metalloproteinase 1(TIMP-1) and hypoxia-inducible factor-1α (HIF-1α) in AF patients with ischemic heart disease (IHD) and/or arterial hypertension (AH), suffering from OSAHS.Material and methods. We examined 140 non-valvular AF patients with IHD and/or AH. Cardiorespiratory monitoring was conducted in the studied subjects and they were divided into 2 groups according to the presence of OSAHS: group 1 – non-OSAHS patients; group 2 – patients with OSAHS. Serum levels of TIMP-1 and HIF-1α were assayed using commercially available ELISA kit.Results. The patients with OSAHS had higher levels of TIMP-1 and HIF-1α than non-OSAHS patients (p<0.05). The levels of TIMP-1 and HIF-1α positively correlated with the severity of OSAHS, as well as with the degree of atrial dilatation and left ventricular hypertrophy (p<0.05). Multiple regression showed a link between the levels of TIMP-1, HIF-1α and the respiratory disturbance index (β=0.418; p<0.001 and β=0.697; p<0.001 respectively).Conclusion. Presence of OSAHS in AF patients with IHD and/or AH is associated with increased serum levels of TIMP-1 and HIF-1α, and thus modifies the ECM of cardiovascular tissues.