STUDY OBJECTIVES: The electrocardiogram (ECG)-based sleep spectrogram generates a map of cardiopulmonary coupling based on heart rate variability and respiration derived from QRS amplitude variations. A distinct spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFC(NB)), has been associated with central apneas and periodic breathing and predicts sleep laboratory failure of continuous positive airway pressure therapy. This study assesses, at a population level, the associations of this spectrographic biomarker with prevalent cardiovascular disease using the Sleep Heart Health Study (SHHS)-I dataset. DESIGN: Retrospective analysis of the Sleep Heart Health Study-I dataset. SETTING: Laboratory for complex physiologic signals analysis. MEASUREMENTS AND RESULTS: The fully-automated ECG-derived sleep spectrogram technique was applied to 5247 (of the original 6441) polysomnograms from the SHHS-I. Associations were estimated with use of various drugs and pathologies including prevalent hypertension and cardiovascular and cerebrovascular disease. Increasing with age and more common in males, e-LFC(NB) is also associated with greater severity of sleep apnea and fragmented sleep. After adjustment for potential confounders, an independent association with prevalent hypertension and stroke was found. CONCLUSIONS: An ECG-derived spectrographic marker related to low frequency cardiopulmonary coupling is associated with greater sleep apnea severity. Whether this biomarker is solely a sign of more severe disease or whether it reflects primary alterations in sleep apnea pathophysiology (which may either cause or result from sleep apnea) is unknown. This ECG-based spectral marker is associated with a higher prevalence of hypertension and stroke.
STUDY OBJECTIVES: The electrocardiogram (ECG)-based sleep spectrogram generates a map of cardiopulmonary coupling based on heart rate variability and respiration derived from QRS amplitude variations. A distinct spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFC(NB)), has been associated with central apneas and periodic breathing and predicts sleep laboratory failure of continuous positive airway pressure therapy. This study assesses, at a population level, the associations of this spectrographic biomarker with prevalent cardiovascular disease using the Sleep Heart Health Study (SHHS)-I dataset. DESIGN: Retrospective analysis of the Sleep Heart Health Study-I dataset. SETTING: Laboratory for complex physiologic signals analysis. MEASUREMENTS AND RESULTS: The fully-automated ECG-derived sleep spectrogram technique was applied to 5247 (of the original 6441) polysomnograms from the SHHS-I. Associations were estimated with use of various drugs and pathologies including prevalent hypertension and cardiovascular and cerebrovascular disease. Increasing with age and more common in males, e-LFC(NB) is also associated with greater severity of sleep apnea and fragmented sleep. After adjustment for potential confounders, an independent association with prevalent hypertension and stroke was found. CONCLUSIONS: An ECG-derived spectrographic marker related to low frequency cardiopulmonary coupling is associated with greater sleep apnea severity. Whether this biomarker is solely a sign of more severe disease or whether it reflects primary alterations in sleep apnea pathophysiology (which may either cause or result from sleep apnea) is unknown. This ECG-based spectral marker is associated with a higher prevalence of hypertension and stroke.
Authors: Mario Giovanni Terzano; Liborio Parrino; Arianna Smerieri; Ronald Chervin; Sudhansu Chokroverty; Christian Guilleminault; Max Hirshkowitz; Mark Mahowald; Harvey Moldofsky; Agostino Rosa; Robert Thomas; Arthur Walters Journal: Sleep Med Date: 2002-03 Impact factor: 3.492
Authors: F J Nieto; T B Young; B K Lind; E Shahar; J M Samet; S Redline; R B D'Agostino; A B Newman; M D Lebowitz; T G Pickering Journal: JAMA Date: 2000-04-12 Impact factor: 56.272
Authors: Hideaki Nakayama; Curtis A Smith; Joshua R Rodman; James B Skatrud; Jerome A Dempsey Journal: Am J Respir Crit Care Med Date: 2002-05-01 Impact factor: 21.405
Authors: Robert Joseph Thomas; Joseph E Mietus; Chung-Kang Peng; Geoffrey Gilmartin; Robert W Daly; Ary L Goldberger; Daniel J Gottlieb Journal: Sleep Date: 2007-12 Impact factor: 5.849
Authors: Timothy I Morgenthaler; Janet B Croft; Leslie C Dort; Lauren D Loeding; Janet M Mullington; Sherene M Thomas Journal: J Clin Sleep Med Date: 2015-09-15 Impact factor: 4.062
Authors: Nathaniel A Eiseman; M Brandon Westover; Joseph E Mietus; Robert J Thomas; Matt T Bianchi Journal: J Sleep Res Date: 2011-07-14 Impact factor: 3.981