Document Detail

Utility of overnight pulse oximetry and heart rate variability analysis to screen for sleep-disordered breathing in chronic heart failure.
MedLine Citation:
PMID:  22807517     Owner:  NLM     Status:  Publisher    
BACKGROUND: Sleep-disordered breathing (SDB) is under diagnosed in chronic heart failure (CHF). Screening with simple monitors may increase detection of SDB in a cardiology setting. This study aimed to evaluate the accuracy of heart rate variability analysis and overnight pulse oximetry for diagnosis of SDB in patients with CHF. METHODS: 180 patients with CHF underwent simultaneous polysomnography, ambulatory electrocardiography and wrist-worn overnight pulse oximetry. SDB was defined as an apnoea-hypopnoea index ≥15/h. To identify SDB from the screening tests, the per cent very low frequency increment (%VLFI) component of heart rate variability was measured with a pre-specified cutoff ≥2.23%, and the 3% oxygen desaturation index was measured with a pre-specified cutoff >7.5 desaturations/h. RESULTS: 173 patients with CHF had adequate sleep study data; SDB occurred in 77 (45%) patients. Heart rate variability was measurable in 78 (45%) patients with area under the %VLFI receiver operating characteristic curve of 0.50. At the ≥2.23% cutoff, %VLFI sensitivity was 58% and specificity was 48%. The 3% oxygen desaturation index was measurable in 171 (99%) patients with area under the curve of 0.92. At the pre-specified cutoff of >7.5 desaturations/h, the 3% oxygen desaturation index had a sensitivity of 97%, specificity of 32%, negative likelihood ratio of 0.08 and positive likelihood ratio of 1.42. Diagnostic accuracy was increased using a cutoff of 12.5 desaturations/h, with sensitivity of 93% and specificity of 73%. CONCLUSIONS: The high sensitivity and low negative likelihood ratio of the 3% oxygen desaturation index indicates that pulse oximetry would be of use as a simple screening test to rule out SDB in patients with CHF in a cardiology setting. The %VLFI component of heart rate variability is not suitable for detection of SDB in CHF.
Neil R Ward; Martin R Cowie; Stuart D Rosen; Vitor Roldao; Manuel De Villa; Theresa A McDonagh; Anita Simonds; Mary J Morrell
Related Documents :
3970667 - Reliability and sensitivity of frozen-section pancreatic biopsy.
16685607 - Transgastric endoscopic ultrasound-guided fine-needle aspiration biopsy and flow cytome...
21660907 - Comparison of transnasal small-caliber vs. peroral conventional esophagogastroduodenosc...
20853047 - Does blue dye contribute to success of sentinel node mapping for breast cancer?
24621777 - Perioperative sequential monitoring of hemodynamic parameters in patients with pheochro...
570997 - Erythropoietin levels in uremic nephric and anephric patients.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-17
Journal Detail:
Title:  Thorax     Volume:  -     ISSN:  1468-3296     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Clinical and Academic Department of Sleep and Breathing, National Heart and Lung Institute and NIHR Biomedical Research Unit, Royal Brompton Hospital and Imperial College, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  British Thoracic Society national bronchiectasis audit 2010 and 2011.
Next Document:  World Health Organization group 5 drugs for the treatment of drug-resistant tuberculosis: unclear ef...