The prevalence of OSAHS (obstructive sleep apnoea/hypopnoea syndrome) is high in developed countries and it is estimated that the vast majority of patients remain undiagnosed. On the basis of physiological evidence, we evaluated the frequency component of HRI (heart rate increment) as a simple and inexpensive screening tool for OSAHS detection in a first group of patients (group 1) and validated their discriminant capacity in a second group (group 2). The predictive accuracy of hourly %VLFI (frequency-domain HRI variable obtained from nocturnal ECG Holter monitoring) was analysed by comparison with an hour-by-hour respiratory disturbances index assessed by complete polysomnography in 28 consecutive clinically suspected OSAHS patients for group 1 and in 35 patients for group 2. OSAHS was present in 20 patients according to a mean hourly apnoea plus hypopnoea index >10 in group 1, and prevalence reached 77.1% in group 2. Sensitivity, specificity and positive and negative predictive accuracy were calculated and an ROC (receiver operating characteristic) curve was constructed for several polysomnographic threshold values. In group 1, hourly %VLFI appeared as an evident predictor of the apnoea/hypopnoea index (W=0.848, P<0.0001; where W is the area under the curve obtained using ROC curve analysis). Using an appropriate threshold (value ≥3.2%), %VLFI demonstrated a sensitivity of 78.1% and a specificity of 70.4%. These thresholds applied to group 2 yielded a sensitivity of 73.9% and a specificity of 76.6%. Frequency-domain analysis of the HRI appears to be a powerful tool for OSAHS prediction. The simplicity of its analysis and use makes of it a particularly well-suited variable for routine mass screening in high-risk populations undergoing ECG Holter monitoring.
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July 2004
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Research Article|
June 23 2004
Heart rate increment: an electrocardiological approach for the early detection of obstructive sleep apnoea/hypopnoea syndrome
Frédéric ROCHE;
*Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie-PPEH, Groupe de Recherche SYNAPSE, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France
Correspondence: Dr Frédéric Roche (e-mail Frederic.Roche@univ-st-etienne.fr).
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Emilia SFORZA;
Emilia SFORZA
†Laboratoire du Sommeil, Laboratoire de NeuroPhysiologie, Hôpital Belle Idée, Hôpitaux Universitaires, Geneva, Switzerland
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David DUVERNEY;
David DUVERNEY
*Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie-PPEH, Groupe de Recherche SYNAPSE, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France
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Jean-René BORDERIES;
Jean-René BORDERIES
‡Novacor SA, Rueil-Malmaison, France
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Vincent PICHOT;
Vincent PICHOT
*Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie-PPEH, Groupe de Recherche SYNAPSE, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France
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Odile BIGAIGNON;
Odile BIGAIGNON
‡Novacor SA, Rueil-Malmaison, France
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Gilles ASCHER;
Gilles ASCHER
‡Novacor SA, Rueil-Malmaison, France
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Jean-Claude BARTHÉLÉMY
Jean-Claude BARTHÉLÉMY
*Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie-PPEH, Groupe de Recherche SYNAPSE, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France
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Clin Sci (Lond) (2004) 107 (1): 105–110.
Article history
Received:
February 05 2004
Accepted:
March 02 2004
Accepted Manuscript online:
March 02 2004
Citation
Frédéric ROCHE, Emilia SFORZA, David DUVERNEY, Jean-René BORDERIES, Vincent PICHOT, Odile BIGAIGNON, Gilles ASCHER, Jean-Claude BARTHÉLÉMY; Heart rate increment: an electrocardiological approach for the early detection of obstructive sleep apnoea/hypopnoea syndrome. Clin Sci (Lond) 1 July 2004; 107 (1): 105–110. doi: https://doi.org/10.1042/CS20040036
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