基于自动识别的去饱和的低氧负荷与不良健康结果相关。

IF 6.8 2区 医学 Q1 RESPIRATORY SYSTEM
Neda Esmaeili, Gonzalo Labarca, Wen-Hsin Hu, Daniel Vena, Ludovico Messineo, Laura Gell, Mohammadreza Hajipour, Luigi Taranto-Montemurro, Scott A Sands, Susan Redline, Andrew Wellman, Mohammadreza Sehhati, Ali Azarbarzin
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引用次数: 0

摘要

理由:最近的研究表明,在社区和临床队列中,通过缺氧负荷(HB)量化的睡眠呼吸暂停特异性间歇性低氧血症可以预测心血管疾病(CVD)相关的死亡率。HB的计算是基于对低通气和呼吸暂停的手动评分,这是耗时的,并且容易发生心间变异。目的:验证一种新的基于自动评分去饱和的HB定量方法。方法:样本包括来自睡眠心脏健康研究的5655名中老年人(52.8%为女性;年龄63.2岁 ± 11.3 年)。最初的HB方法基于从氧饱和度信号的整体平均值(通过脉搏血氧计测量)获得的受试者特定搜索窗口,并与评分的呼吸事件的终止同步。然而,在这项研究中,搜索窗口是从氧饱和度信号的系综平均值获得的,该信号与所有自动识别的去饱和中的最小值同步(在灵敏度分析中,2%和其他阈值,包括3%和4%)。在最小饱和度附近的两个最大值之间的时间间隔被定义为搜索窗口。血氧测定衍生的HB(HBOxi)定义为所有去饱和曲线下的总面积(受搜索窗口限制)除以总睡眠时间。Logistic和Cox回归模型评估了在调整了几个协变量和混杂因素后,HBOxi中每增加1个标准差,日间过度嗜睡(EDS)、高血压(HTN)和心血管疾病死亡率的调整比值比(aOR)/风险比。结果:HB(中位数[四分位间距],34.4[18.4-59.8]%min/h)与HBOxi(中位数[四分位间距]34.5[21.6-53.8]%min.h)之间的Spearman秩相关性为0.81(P 在完全调整的模型中,Oxi与EDS(aOR[95%置信区间(CI)],每个标准差1.17[1.09-12.6])、HTN(aOR=95%CI],1.13[1.05-1.21])和CVD死亡率(调整后的危险比[95%CI]、1.15[1.01-1.30])显著相关。结论:根据人工评分的呼吸暂停和低通气,HBOxi与HB高度相关,并与EDS、HTN和CVD死亡率相关,其影响大小与先前报道的相似。这种方法可以结合到可穿戴技术中,精确记录氧饱和度信号。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hypoxic Burden Based on Automatically Identified Desaturations Is Associated with Adverse Health Outcomes.

Rationale: Recent studies have shown that sleep apnea-specific intermittent hypoxemia quantified by the hypoxic burden (HB) predicted cardiovascular disease (CVD)-related mortality in community-based and clinical cohorts. Calculation of HB is based on manual scoring of hypopneas and apneas, which is time-consuming and prone to interscorer variability. Objective: To validate a novel method to quantify the HB that is based on automatically scored desaturations. Methods: The sample included 5,655 middle-aged or older adults from the Sleep Heart Health Study (52.8% women; age, 63.2 ± 11.3 yr). The original HB method was based on a subject-specific search window obtained from an ensemble average of oxygen saturation signals (as measured by pulse oximetry) and synchronized with respect to the termination of scored respiratory events. In this study, however, the search window was obtained from ensemble average of oxygen saturation signals that synchronized with respect to the minimum of all automatically identified desaturations (⩾2% and other thresholds, including 3% and 4%, in sensitivity analyses). The time interval between the two maxima around the minimum saturation was defined as the search window. The oximetry-derived HB (HBOxi) was defined as the total area under all desaturation curves (restricted by the search window) divided by the total sleep time. Logistic and Cox regression models assessed the adjusted odds ratio (aOR)/hazard ratio of excessive daytime sleepiness (EDS), hypertension (HTN), and CVD mortality per 1-standard deviation increase in HBOxi after adjusting for several covariates and confounders. Results: The Spearman's rank correlation between HB (median [interquartile range], 34.4 [18.4-59.8] % min/h) and HBOxi (median [interquartile range], 34.5 [21.6-53.8] % min/h) was 0.81 (P < 0.001). Similar to HB, HBOxi was significantly associated with EDS (aOR [95% confidence interval (CI)], 1.17 [1.09-1.26] per standard deviation), HTN (aOR [95% CI], 1.13 [1.05-1.21]), and CVD mortality (adjusted hazard ratio [95% CI], 1.15 [1.01-1.30]) in fully adjusted models. Conclusions: The HBOxi was highly correlated with the HB based on manually scored apneas and hypopneas and was associated with EDS, HTN, and CVD mortality with similar effect sizes as previously reported. This method could be incorporated into wearable technology that accurately records oxygen saturation signals.

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来源期刊
Annals of the American Thoracic Society
Annals of the American Thoracic Society Medicine-Pulmonary and Respiratory Medicine
CiteScore
9.30
自引率
3.60%
发文量
0
期刊介绍: The Annals of the American Thoracic Society (AnnalsATS) is the official international online journal of the American Thoracic Society. Formerly known as PATS, it provides comprehensive and authoritative coverage of a wide range of topics in adult and pediatric pulmonary medicine, respiratory sleep medicine, and adult medical critical care. As a leading journal in its field, AnnalsATS offers up-to-date and reliable information that is directly applicable to clinical practice. It serves as a valuable resource for clinical specialists, supporting their formative and continuing education. Additionally, the journal is committed to promoting public health by publishing research and articles that contribute to the advancement of knowledge in these fields.
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