Role of biomarkers of collagen metabolism and systemic inflammation in myocardial remodeling in patients with stable chronic coronary artery disease and obstructive sleep apnea

Abstract

Aim. To study the relationship of biomarkers of collagen metabolism and systemic inflammation with left ventricular (LV) remodeling in patients with stable coronary artery disease (CAD) and obstructive sleep apnea (OSA).Material and methods. The study included 195 patients with stable CAD, of which 63 without OSA and 132 patients with combination of CAD and OSA. The mean age of patients was 63,4±3,7 years. Biomarkers of collagen metabolism and systemic inflammation were assessed by determining the concentration of matrix metalloproteinase (MMP)-9, tissue inhibitor of matrix metalloproteinase-1, monocyte chemoattractant protein-1 (MCP-1) and calculating the neutrophil-to-lymphocyte (NLR) and platelet-tolymphocyte ratio (PLR). Echocardiography was performed according to a standard protocol.Results. There were no significant differences in systemic inflammation parameters (MCP-1, NLR, PLR) between the group of patients with CAD and CAD with mild OSA and a significantly higher level of MCP-1, NLR, PLR in more severe OSA. In patients with CAD and severe OSA, the eccentric LV remodeling was diagnosed in 75% of individuals, while the concentric type was diagnosed in only 25%.Conclusion. In patients with stable CAD, the more severe the OSA, the more pronounced systemic inflammation (MCP-1, NLR, PLR), and there are higher proportion of eccentric LV hypertrophy, which may be associated with an imbalance of fibrosis markers (high concentration of MMP-9 with an almost unchanged level of tissue inhibitor of MMP-1).

Keywords

• coronary artery disease
• obstructive sleep apnea
• systemic inflammation
• collagen metabolism
• myocardial remodeling