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The predictive value of Holter monitoring in the risk of obstructive sleep apnea

BACKGROUND: Patients with obstructive sleep apnea (OSA) often present with cardiovascular symptoms. Holter monitors were reported to predict sleep apnea, though were rarely used in everyday clinical practice. In this study, by comparing Holter monitoring to polysomnography (PSG), we try to find out...

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Autores principales: Lao, Miaochan, Ou, Qiong, Li, Cui’e, Wang, Qian, Yuan, Ping, Cheng, Yilu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024822/
https://www.ncbi.nlm.nih.gov/pubmed/33841975
http://dx.doi.org/10.21037/jtd-20-3078
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author Lao, Miaochan
Ou, Qiong
Li, Cui’e
Wang, Qian
Yuan, Ping
Cheng, Yilu
author_facet Lao, Miaochan
Ou, Qiong
Li, Cui’e
Wang, Qian
Yuan, Ping
Cheng, Yilu
author_sort Lao, Miaochan
collection PubMed
description BACKGROUND: Patients with obstructive sleep apnea (OSA) often present with cardiovascular symptoms. Holter monitors were reported to predict sleep apnea, though were rarely used in everyday clinical practice. In this study, by comparing Holter monitoring to polysomnography (PSG), we try to find out an operable way for clinicians to use Holter to predict OSA risk. METHODS: Patients (n=63) suspected of OSA underwent Holter monitoring with concurrent PSG at a sleep center. Respiration and heart rate variability (HRV) indices were calculated from the Holter and compared with PSG indices. RESULTS: The sensitivity of the Holter-derived respiratory waveform for OSA was 90.0%, and the specificity was 82.6%. The time domain indices including standard deviation of all NN intervals during 24 hours, mean of standard deviation of the averages of NN intervals in all 5-minute segments, square root of the mean squared differences of successive NN intervals, percentage of beat-to-beat NN interval differences that were more than 50 milliseconds, and the frequency domain index of high frequency decreased in participants with OSA and correlated with the PSG derived indices including apnea-hypopnea index (AHI), oxygen reduction index (ODI) and nadir SaO(2). Logistic regression showed that standard deviation of all NN intervals during 24 hours and gender could predict the risk of OSA (P<0.001), with a sensitivity for diagnosing moderate to severe OSA of 87.5% and could accurately distinguish the risk of OSA in 77.8% of patients. Males with standard deviation of all NN intervals during 24 hours ≤177 ms or females with standard deviation of all NN intervals during 24 hours ≤80.9 ms were considered to be at high risk for OSA. CONCLUSIONS: Commercial and common parameters from Holter monitoring could predict the risk of OSA with high sensitivity. Therefore, the risk of OSA may be assessed using the Holter examination to improve the diagnosis and treatment rate of OSA.
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spelling pubmed-80248222021-04-08 The predictive value of Holter monitoring in the risk of obstructive sleep apnea Lao, Miaochan Ou, Qiong Li, Cui’e Wang, Qian Yuan, Ping Cheng, Yilu J Thorac Dis Original Article for Sleep Section BACKGROUND: Patients with obstructive sleep apnea (OSA) often present with cardiovascular symptoms. Holter monitors were reported to predict sleep apnea, though were rarely used in everyday clinical practice. In this study, by comparing Holter monitoring to polysomnography (PSG), we try to find out an operable way for clinicians to use Holter to predict OSA risk. METHODS: Patients (n=63) suspected of OSA underwent Holter monitoring with concurrent PSG at a sleep center. Respiration and heart rate variability (HRV) indices were calculated from the Holter and compared with PSG indices. RESULTS: The sensitivity of the Holter-derived respiratory waveform for OSA was 90.0%, and the specificity was 82.6%. The time domain indices including standard deviation of all NN intervals during 24 hours, mean of standard deviation of the averages of NN intervals in all 5-minute segments, square root of the mean squared differences of successive NN intervals, percentage of beat-to-beat NN interval differences that were more than 50 milliseconds, and the frequency domain index of high frequency decreased in participants with OSA and correlated with the PSG derived indices including apnea-hypopnea index (AHI), oxygen reduction index (ODI) and nadir SaO(2). Logistic regression showed that standard deviation of all NN intervals during 24 hours and gender could predict the risk of OSA (P<0.001), with a sensitivity for diagnosing moderate to severe OSA of 87.5% and could accurately distinguish the risk of OSA in 77.8% of patients. Males with standard deviation of all NN intervals during 24 hours ≤177 ms or females with standard deviation of all NN intervals during 24 hours ≤80.9 ms were considered to be at high risk for OSA. CONCLUSIONS: Commercial and common parameters from Holter monitoring could predict the risk of OSA with high sensitivity. Therefore, the risk of OSA may be assessed using the Holter examination to improve the diagnosis and treatment rate of OSA. AME Publishing Company 2021-03 /pmc/articles/PMC8024822/ /pubmed/33841975 http://dx.doi.org/10.21037/jtd-20-3078 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article for Sleep Section
Lao, Miaochan
Ou, Qiong
Li, Cui’e
Wang, Qian
Yuan, Ping
Cheng, Yilu
The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title_full The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title_fullStr The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title_full_unstemmed The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title_short The predictive value of Holter monitoring in the risk of obstructive sleep apnea
title_sort predictive value of holter monitoring in the risk of obstructive sleep apnea
topic Original Article for Sleep Section
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024822/
https://www.ncbi.nlm.nih.gov/pubmed/33841975
http://dx.doi.org/10.21037/jtd-20-3078
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