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Heart rate increment analysis is not effective for sleep-disordered breathing screening in patients with chronic

Thibaud Damy1, Marie-Pia D'Ortho, Brigitte Estrugo

  • 1Fédération de Cardiologie, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Hôpital Henri Mondor, 51 Avenue Maréchal de Lattre de Tassigny, Créteil, France. thibaud.damy@hmn.aphp.fr

Journal of Sleep Research
|September 8, 2009
PubMed

Insights

Frequency domain analysis of heart rate variability is not a reliable screening tool for sleep-disordered breathing in patients with chronic heart failure. This method showed poor accuracy and is not recommended for this population.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Biomedical Engineering

Background:

  • Frequency domain analysis of heart rate variability (HRV) is a potential screening tool for sleep-disordered breathing (SDB) in the general population.
  • Chronic heart failure (CHF) patients often experience SDB, impacting their health outcomes.
  • Assessing the utility of HRV in SDB screening within the CHF population is crucial.

Purpose of the Study:

  • To evaluate the effectiveness of frequency domain analysis of HRV as a screening tool for SDB in patients with chronic heart failure (CHF).
  • To determine if %VLFI can accurately identify SDB in CHF patients.

Main Methods:

  • Prospective study of 84 stable CHF patients (LVEF <45%, sinus rhythm).
  • Simultaneous polygraphy (to measure AHI) and Holter ECG monitoring (to measure %VLFI).
  • Correlation and ROC curve analysis to assess %VLFI's association with SDB (AHI ≥15 h⁻¹).

Main Results:

  • SDB was diagnosed in 57.4% of the 54 evaluable CHF patients.
  • %VLFI showed no significant correlation with AHI (r=0.12).
  • The recommended %VLFI cut-off for the general population demonstrated low specificity (35%) and predictive values in CHF patients.

Conclusions:

  • Heart rate variability analysis has significant limitations in screening for SDB in CHF patients.
  • The %VLFI metric is not a recommended screening tool for SDB in this specific patient group.
  • Further research may be needed to identify reliable SDB screening methods for CHF populations.

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