RT Journal Article
SR Electronic
T1 Prediction of cardiovascular risk from nocturnal pulse wave signal using the autonomic state indicator technology
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3285
VO 40
IS Suppl 56
A1 Dirk Sommermeyer
A1 Ding Zou
A1 Derek Eder
A1 Jan Hedner
A1 Joachim Ficker
A1 Winfried Randerath
A1 Thomas Penzel
A1 Bernd Sanner
A1 Ludger Grote
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3285.abstract
AB IntroductionAnalysis of continuous physiological signals measured by pulse oximetry during sleep may provide a novel method to assess cardiovascular (CV) risk. The sleep period appears to be a particularly useful window for assessment.MethodsSubjects (n=520, 346 males, age 55.0±13.4 yrs, BMI 29.9±6.1 kg/m2) were referred to five sleep centers in Germany and Sweden. CV risk factors were assessed and subjects were classified by the ESC/ESH risk matrix into five separate risk classes. The autonomic state indicator (ASI) algorithm extracted patterns of the peripheral pulse wave and SpO2 signal by amplitude and time/frequency analysis from the overnight digital photoplethysmographic recording and computed a CV risk score (range 0-1, ≥0.5 equals to high risk). Nine derived parameters (irregular pulse, RCDC, pulse rate variability, pulse wave variability, pulse propagation time, oxygen desaturations, duration of periodic symmetric desaturations and baseline SpO2) were used to determine the final score.ResultsIn the validation group (n=390), the developed algorithm detected high CV risk (ESC/ESH scores 4 and 5) patients with a sensitivity of 74.5% and specificity of 76.4%. The area under the ROC curve was 0.80. The ASI CV risk score was elevated in patients with an already established CV endpoint (MI and/or stroke, n=50) compared with all other patients (0.73±0.27 vs. 0.42±0.34, p<0.001).ConclusionsThe ASI technique appears to provide a possibility to detect increased CV risk from a recording of physiological signals during sleep. The technique – based on a modified pulse oximeter – may be useful in both sleep and cardiovascular medicine.