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Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure

Depts of ¹ Pneumology, ² Cardiology, and ³ Neurophysiology, Virgen del Rocio Hospital, and ⁴ Dept of Statistics, Sevilla University, Sevilla, Spain

CORRESPONDENCE: E. Quintana-Gallego, Dept of Pneumology, Virgen del Rocio Hospital, Manuel Siurot s/n, E-41013, Sevilla, Spain. Fax: 34 955012199. E-mail: mqg01se@saludalia.com

Keywords: Central sleep apnoea, diagnosis, heart failure, obstructive sleep apnoea, portable devices, sleep-disordered breathing

Received: December 18, 2003
Accepted May 12, 2004

This study was supported by a grant from Consejería de Salud, Junta de Andalucía, Spain (154/00) and by Red Respira (RTIC 03/11, Fondo de Investigación Sanitaria, Instituto San Carlos III).

The present study assessed the usefulness of home cardiorespiratory polygraphy as an alternative to overnight polysomnography for the diagnosis of sleep-disordered breathing in heart failure.

A total of 75 patients with chronic stable heart failure due to systolic dysfunction (left ventricular ejection fraction 45%) underwent polysomnography at the Virgen del Rocio Hospital and cardiorespiratory polygraphy at home. The two studies were performed in random order and within 30 days. The accuracy of polygraphical findings was determined by sensitivity and specificity obtained by area under the receiver operating characteristics (ROC) curves for apnoea-hypopnoea index (AHI) thresholds of 5, 10 and 15 in the polysomnography.

The area under the ROC curve for AHI 5, 10 and 15 was 0.896, 0.907 and 0.862, respectively. The diagnostic accuracy of polygraphy compared with polysomnography ranged 78.6–84%, with sensitivities of 68.4–82.5%, and specificities of 88.6–97.8% for the different AHI thresholds. Altogether, 29 patients had an AHI 10 (central pattern 24, obstructive pattern 5). Sensitivity and specificity of home polygraphy for identifying the sleep-disordered breathing pattern was 100%.

These data show that home cardiorespiratory polygraphy has a high sensitivity and specificity for the diagnosis of sleep-disordered breathing associated with heart failure.

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