Use of high-frequency peak in spectral analysis of heart rate increment to improve screening of obstructive sleep apnoea
Use of high-frequency peak in spectral analysis of heart rate increment to improve screening of obstructive sleep apnoea
复制标题
DOI：
10.1007/s11325-010-0446-0
复制
发表时间：
2011-12-01
影响因子：
2.5
通讯作者：
Roche, Frederic
中科院分区：
文献类型：
--
作者：
Poupard, Laurent;Court-Fortune, Isabelle;Roche, Frederic
目的研究心率增快的极低频功率谱密度（%VLFI）与阻塞性睡眠呼吸暂停综合征（OSAS）的相关性。然而，患者的心率变异性受损可能会表现出很大的变化的心率增量（HRI）的频谱模式，并改变筛选的准确性的methods.Methods为了克服这一限制，本研究使用的高频增量（HFI）峰在HRI频谱，这对应于呼吸的影响RR的变化在频率范围0.2至0.4 Hz。我们评估了288例连续的打鼾患者，观察夜间呼吸停止和/或白天嗜睡。如果患者在多导睡眠图中的呼吸暂停加呼吸不足指数（AHI）超过每小时15次，则将其归类为OSAS。结果以%VLFI阈值> 2.4%为OSAS诊断标准，敏感性为74.9%，特异性为51%，阳性预测值为54.9%，阴性预测值为71.7%（假阴性33例）。使用阈值为%VLFI > 2.4%和HFI峰位置> 0.4 Hz，阴性预测值增加到78.2%，同时保持特异性在50.6%。在11例%VLFI <0.4Hz的受试者中< 2.4% and HFI peak >，9例表现为中度至重度OSAS（AHI > 30）。结论HFI是应用%VLFI的最低生理标准，可确保心率变化受频带频率限制。
Purpose Several studies have correlated the ratio of the very low frequency power spectral density of heart rate increment (%VLFI) with obstructive sleep apnoea syndrome (OSAS). However, patients with impaired heart rate variability may exhibit large variations of heart rate increment (HRI) spectral pattern and alter the screening accuracy of the method.Methods To overcome this limitation, the present study uses the high-frequency increment (HFI) peak in the HRI spectrum, which corresponds to the respiratory influence on RR variations over the frequency range 0.2 to 0.4 Hz. We evaluated 288 consecutive patients referred for snoring, observed nocturnal breathing cessation and/or daytime sleepiness. Patients were classified as OSAS if their apnoea plus hypopnoea index (AHI) during polysomnography exceeded 15 events per hour. Synchronized electrocardiogram Holter monitoring allowed HRI analysis.Results Using a %VLFI threshold > 2.4% for identifying the presence of OSAS, sensitivity for OSAS was 74.9%, specificity 51%, positive predictive value 54.9% and negative predictive value 71.7% (33 false negative subjects). Using threshold for %VLFI > 2.4% and HFI peak position > 0.4 Hz, negative predictive value increased to 78.2% while maintaining specificity at 50.6%. Among 11 subjects with %VLFI < 2.4% and HFI peak > 0.4 Hz, nine demonstrated moderate to severe OSAS (AHI > 30).Conclusions HFI represents a minimal physiological criterion for applying %VLFI by ensuring that heart rate variations are band frequency limited.