Obstructive Sleep Apnea and Circulating Potassium Channel Levels

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Samuel C. Dudley¹  Guangbin Shi¹  Bahaa Kaseer¹  Hafiz Imran¹  Ning Jiang¹  Anyu Zhou¹  Richard Millman²  Jimmy Doumit³  Li Zhou³  Bharati Prasad³ 

[1] Lifespan Cardiovascular Institute, Brown University, Providence, RI;Rhode Island Hospital, Brown University, Providence, RI;University of Illinois at Chicago, IL;

关键词: arrhythmia;    gene regulation;    hypoxia;    ion channel;    potassium‐channel;    sleep apnea;   

DOI  :  10.1161/JAHA.116.003666

来源: DOAJ

【 摘 要 】

BackgroundCardiac arrhythmias and sudden cardiac death are more frequent in patients with obstructive sleep apnea (OSA). OSA is associated with QT prolongation, and QT prolongation is an independent risk factor for sudden cardiac death. Because QT prolongation can be mediated by potassium channel loss of function, we tested whether OSA or continuous positive airway pressure therapy altered mRNA expression of circulating white blood cell potassium channels. Methods and ResultsIn total, 28 patients with OSA newly diagnosed by polysomnogram and 6 participants without OSA were enrolled. Potassium channel levels in white blood cells at baseline and at a 4‐week follow‐up visit were compared. There was a significant inverse correlation between the severity of the OSA stratified by apnea–hypopnea index and mRNA expression of the main potassium channels assessed: KCNQ1 (r=−0.486, P=0.007), KCNH2 (r=−0.437, P=0.016), KCNE1 (r=−0.567, P=0.001), KCNJ2 (r=−0.442, P=0.015), and KCNA5 (r=−0.468, P=0.009). In addition, KCNQ1, KCNH2, and KCNE1 inversely correlated with the oxygen desaturation index 4. After 4 weeks of continuous positive airway pressure therapy, circulating KCNQ1 and KCNJ2 were increased 1.4±0.4‐fold (P=0.040) and 2.1±1.4‐fold (P=0.046) in the moderate OSA group. Compared with patients with mild or moderate OSA, patients with severe OSA had a persistently higher apnea–hypopnea index (mild 2.0±1.8, moderate 1.0±0.9, severe 5.8±5.6; P=0.015), perhaps explaining why the potassium channel changes were not seen in the severe OSA group. ConclusionsThe mRNA expression of most potassium channels inversely correlates with the severity of OSA and hypoxemia. Continuous positive airway pressure therapy improves circulating KCNQ1 and KCNJ2 in patients with moderate OSA.

【 授权许可】

Unknown