Ribeiro Sílvia, Bonito Laura, Guimarães Maria José, Português João, Rodrigues Bernardete, Alves Assunção, Durães Célia, Ferreira Daniela, Sanfins Victor, Lourenço António
Serviço de Cardiologia, Hospital Nossa Senhora da Oliveira, Guimarães, Portugal.
Serviço de Medicina Interna, Centro Hospitalar Lisboa Central, Hospital de São José, Lisboa, Portugal.
Rev Port Cardiol (Engl Ed). 2019 Jun;38(6):451-455. doi: 10.1016/j.repc.2018.06.002. Epub 2019 Jul 15.
Sleep Apnea Syndrome (SAS) is a prevalent respiratory disease with marked expression in the population with cardiovascular disease. The diagnosis is based on polysomnography. In patients with cardiac implantable electronic devices (CIED), the prevalence of SAS may reach 60%. The objective of this study was to evaluate the value of DEC in the SAS screening.
Prospective study that included patients with CIED with sleep apnea algorithm. The frequency response function was activated and simplified polygraphy was performed. The data of the device were collected on the day of the polygraph.
The sample included 29 patients, with a mean age of 76.1 years, 71.4% of the male gender. The prevalence of SAS was 77%. For SAS, the agreement between polysomnography and the Pacemaker was Kappa = 0.54 (p = 0.001), 95% CI (0.28, 0.81) (moderate agreement); for moderate to severe SAS, the agreement was Kappa = 0.73 (p <0.001), 95% CI (0.49, 0.976) (substantial agreement). Severe SAS was obtained: sensitivity 60%, specificity 100%, positive predictive value 100%, negative predictive value 60% and diagnostic accuracy 75%; for moderate to severe SAS: sensitivity of 90%, specificity of 83%, positive predictive values of 90% and negative of 87.5%, with a diagnostic accuracy of 87.5%.
SAS is highly prevalent in patients with CIED. The values obtained through these devices have a strong positive correlation with the Apnea-Hypopnea Índex, which makes them a good tool for the screening of severe SAS.
睡眠呼吸暂停综合征（SAS）是一种常见的呼吸系统疾病，在心血管疾病人群中表现明显。诊断基于多导睡眠图。在植入心脏电子设备（CIED）的患者中，SAS的患病率可能达到60%。本研究的目的是评估DEC在SAS筛查中的价值。
前瞻性研究，纳入具有睡眠呼吸暂停算法的CIED患者。激活频率响应功能并进行简化多导睡眠监测。在多导睡眠监测当天收集设备数据。
样本包括29例患者，平均年龄76.1岁，男性占71.4%。SAS的患病率为77%。对于SAS，多导睡眠图与起搏器之间的一致性Kappa = 0.54（p = 0.001），95%置信区间（0.28, 0.81）（中度一致）；对于中度至重度SAS，一致性Kappa = 0.73（p <0.001），95%置信区间（0.49, 0.976）（高度一致）。重度SAS的结果为：灵敏度60%，特异度100%，阳性预测值100%，阴性预测值60%，诊断准确率75%；对于中度至重度SAS：灵敏度为90%，特异度为83%，阳性预测值为90%，阴性预测值为87.5%，诊断准确率为87.5%。
SAS在CIED患者中高度流行。通过这些设备获得的值与呼吸暂停低通气指数有很强的正相关性，这使其成为筛查重度SAS的良好工具。
