Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company.
Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company.
复制标题
DOI：
10.1007/s11325-012-0681-7
复制
发表时间：
2013-03
影响因子：
2.5
通讯作者：
Fujimoto, Keisaku
中科院分区：
文献类型：
--
作者：
Hayano, Junichiro;Tsukahara, Teruomi;Watanabe, Eiichi;Sasaki, Fumihiko;Kawai, Kiyohiro;Sakakibara, Hiroki;Kodama, Itsuo;Nomiyama, Tetsuo;Fujimoto, Keisaku
关键词：
睡眠呼吸障碍（SDB）与心血管发病率和死亡率以及睡眠相关事故的风险增加有关，但> 75%的患者仍未确诊。我们试图确定基于ECG的SDB检测用于人群筛查时的诊断准确性。一家运输公司的所有男性工人（n = 165;年龄，43 ± 12岁），大多数是卡车司机，接受了标准的夜间多导睡眠图检查。采用自适应阈值自相关波检测算法（ACAT），从多导睡眠监测的单导联心电图信号中检测出与睡眠呼吸障碍相关的心率周期性变异（CVHR）。在165例受试者中，62例（38%）的呼吸暂停低通气指数（AHI）≥5，26例（16%）≥15，16例（10%）≥30。每小时CVHR次数（CVHR指数）与AHI密切相关[r = 0.868（95%CI，0.825-0.901）].检测AHI ≥5、≥15和≥30受试者的受试者工作特征曲线下面积分别为0.796（95% CI，0.727-0.855）、0.974（0.937-0.993）和0.997（0.971-0.999）。根据CVHR指数≥15的预定标准，确定AHI ≥15的受试者的灵敏度为88%，特异性为97%（阳性和阴性检测的似然比分别为30.7和0.12）。在肥胖、高血压、糖尿病、血脂异常和自主神经功能下降的受试者亚组中，分类性能得以保留。通过ACAT算法获得的CVHR可能为在表面健康的男性工人中筛查中度至重度SDB提供有用的标记物。
Sleep-disordered breathing (SDB) is associated with increased risk for cardiovascular morbidity and mortality and for sleepiness-related accidents, but >75 % of the patients remain undiagnosed. We sought to determine the diagnostic accuracy of ECG-based detection of SDB when used for population-based screening. All male workers, mostly truck drivers, of a transport company (n = 165; age, 43 ± 12 years) underwent standard attended overnight polysomnography. Cyclic variation of heart rate (CVHR), a characteristic pattern of heart rate associated with SDB, was detected from single-lead ECG signals during the polysomnography by a newly developed automated algorithm of autocorrelated wave detection with adaptive threshold (ACAT). Among 165 subjects, the apnea–hypopnea index (AHI) was ≥5 in 62 (38 %), ≥15 in 26 (16 %), and ≥30 in 16 (10 %). The number of CVHR per hour (CVHR index) closely correlated with AHI [r = 0.868 (95 % CI, 0.825–0.901)]. The areas under the receiver operating characteristic curves for detecting subjects with AHI ≥5, ≥15, and ≥30 were 0.796 (95 % CI, 0.727–0.855), 0.974 (0.937–0.993), and 0.997 (0.971–0.999), respectively. With a predetermined criterion of CVHR index ≥15, subjects with AHI ≥15 were identified with 88 % sensitivity and 97 % specificity (likelihood ratios for positive and negative test, 30.7 and 0.12). The classification performance was retained in subgroups of subjects with obesity, hypertension, diabetes mellitus, dyslipidemia, and decreased autonomic function. The CVHR obtained by the ACAT algorithm may provide a useful marker for screening for moderate-to-severe SDB among apparently healthy male workers.
登录
查看更多内容
影响因子：
6.9
作者：
Agatsuma, Toshihiko;Fujimoto, Keisaku;Nomiyama, Tetsuo
通讯作者：
Nomiyama, Tetsuo
影响因子：
5
作者：
Punjabi, NM;Shahar, E;Resnick, HE
通讯作者：
Resnick, HE
DOI：
10.1109/titb.2008.2004495
发表时间：
2009-01-01
影响因子：
--
作者：
Khandoker, Ahsan H.;Palaniswami, Marimuthu;Karmakar, Chandan K.
通讯作者：
Karmakar, Chandan K.
影响因子：
2.5
作者：
Poupard, Laurent;Court-Fortune, Isabelle;Roche, Frederic
通讯作者：
Roche, Frederic
影响因子：
--
作者：
SHANNON, DC;CARLEY, DW;BENSON, H
通讯作者：
BENSON, H