Prevalent Hypertension and Stroke in the Sleep Heart Health Study: Association with an ECG-derived Spectrographic Marker of Cardiopulmonary Coupling

Thomas RJ, Weiss MD, Mietus JE, Peng CK, Goldberger AL, Gottlieb DJ.

SLEEP 2009;32(7):897-904

The ECG-based sleep spectrogram generates a map of CPC based on heart rate variability and respiration derived from QRS amplitude variations. A distinct spectrographic type, designated as elevated Low Frequency Coupling Narrow Band (e-LFCNB), has been associated with central apneas and periodic breathing and predicts failure of CPAP therapy. This study assesses, at a population level, the associations of this spectrographic biomarker with prevalent cardiovascular disease using the Sleep Heart Health Study (SHHS)-I dataset.

An ECG derived spectrographic marker related to low frequency is associated with greater sleep apnea severity. Whether this biomarker is solely a sign of more severe disease or whether it reflects primary alterations in sleep apnea pathophysiology, which may either cause or result from sleep apnea, is unknown. This ECG-based spectral marker is associated with a higher prevalence of hypertension and stroke.

Practical Significance:
The presence of e-LFCNB represents for the first time a biomarker for sleep disordered breathing independent of age, sex and body mass has been described.

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