NT-proBNP

NT-proBNP adds prognostic information beyond troponin and baseline clinical risk factors after elective thoracic lung resection. Participants with inefficient sleep had a median NT-proBNP of 3,141 ng/L compared with 1,592 ng/L in efficient sleepers, representing approximately a twofold elevation. Preoperative NT-proBNP was abnormal more often than preoperative hs-cTnI in this cohort. NT-proBNP reflects myocardial wall stretch, haemodynamic strain, and neurohormonal activation. Impaired renal clearance was considered an unlikely explanation for elevated NT-proBNP in inefficient sleepers because renal function was similar across both sleep groups. Sleep restriction and fragmentation may independently elevate NT-proBNP by activating the sympathetic nervous system, raising heart rate, blood pressure, and sympathetic cardiac modulation. Comorbidities that independently raise NT-proBNP, such as atrial fibrillation, sleep-disordered breathing, and dementia, may partly explain why poor sleep efficiency is associated with elevated NT-proBNP, reflecting a higher overall comorbidity burden.