• Takeshi Shimizu, Akiomi Yoshihisa, Shoji Iwaya, Satoshi Abe, Takamasa Sato, Satoshi Suzuki, Takayoshi Yamaki, Koichi Sugimoto, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, and Yasuchika Takeishi.
• Department of Cardiology and Hematology.
• Respir Care. 2015 Jan 1;60(1):72-80.

BackgroundSleep-disordered breathing (SDB) is critically associated with cardiovascular mortality and morbidity, especially in patients with heart failure (HF). However, the majority of SDB patients remain undiagnosed. In contrast, abnormality in heart rate variability has been reported in patients with SDB. To explore an efficient electrocardiogram (ECG)-based screening tool for SDB, we examined the usefulness of cyclic variation in heart rate score (CVHRS) by Holter ECG in subjects with HF.MethodsIn this study, 102 subjects with HF were enrolled. We simultaneously performed Holter ECG with overnight portable sleep monitoring, and we measured the respiratory disturbance index (RDI) and CVHRS. We determined the temporal position of the individual dips comprising the CVHRS using time-domain methods. CVHRS was measured as cyclic and autocorrelated dips in smoothed interbeat interval time series.ResultsThere were 25 subjects with severe SDB (RDI ≥ 30 events/h) and 77 subjects with none-to-moderate SDB (0 ≤ RDI < 30 events/h). There was a significant positive correlation between CVHRS and RDI (r = 0.60, P < .001). In receiver operating characteristic analysis, CVHRS (cutoff of 30 events/h) identified severe SDB with a sensitivity of 82%, a specificity of 77%, and an area under the curve of 0.83.ConclusionsCVHRS determined by Holter ECG is a useful screening index for severe SDB in subjects with HF.Copyright © 2015 by Daedalus Enterprises.

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