Document Detail


Cardiac interbeat interval increment for the identification of obstructive sleep apnea.
MedLine Citation:
PMID:  12358169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of obstructive sleep apnea syndrome (OSAS) is high in developed countries but its diagnosis is costly. Based on physiological evidence, the frequency component of heart rate variability (HRV) was evaluated as a simple and inexpensive diagnostic tool in OSAS. The predictive accuracy of frequency-domain HRV variables obtained from 24-hour ECG Holter monitoring (the power spectral density of the interbeat interval increment of very low frequencies, "VLFIpsd," and its percentage over the total power spectral density, "% VLFI"), and of established time-domain HRV variables were analyzed by comparison with respiratory disturbances indexes assessed by complete polysomnography in 124 consecutive patients (98 men aged 53.8 +/- 11.2 years) with clinically suspected OSAS. OSAS was present in 54 (43.5%) patients according to standard criteria. Using receiver operating characteristic curve analysis, two of the three most powerful predictors were frequency-domain variables: % VLFI (W = 0.80, P < 0.0001), and VL-FIpsd (W = 0.79, P < 0.0001). Using a multiple logistic regression analysis, %VLFI was the most strongly associated with diseased status (adjusted OR: 8.4; 95% CI: 3.4-19.5). Using an appropriate threshold, %VLFI demonstrated a diagnostic sensitivity of 87%. A 3-month continuous positive airway pressure treatment significantly improved the same parameter. Frequency-domain analysis of the interbeat interval increment appears as a powerful tool for OSAS diagnosis and follow-up. The simplicity of its analysis and of its use makes of it a well-suited variable for mass screening of OSAS patients.
Authors:
Frédéric Roche; David Duverney; Isabelle Court-Fortune; Vincent Pichot; Frédéric Costes; Jean-René Lacour; J Anestis Antoniadis; Jean-Michel Gaspoz; Jean-Claude Barthelemy
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  25     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-10-02     Completed Date:  2003-04-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1192-9     Citation Subset:  IM    
Affiliation:
Service d'Exploration Fonctionnelle CardioRespiratoire,CHU-Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France. Frederic.Roche@univ-st-etienne.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Electrocardiography, Ambulatory
Female
Heart Rate*
Humans
Male
Middle Aged
Polysomnography
Predictive Value of Tests
Prospective Studies
ROC Curve
Sensitivity and Specificity
Sleep Apnea, Obstructive / diagnosis*,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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