RT info:eu-repo/semantics/article
T1 Assessment of nocturnal autonomic cardiac imbalance in positional obstructive sleep apnea. A multiscale nonlinear approach
A1 Álvarez González, Daniel
A1 Arroyo Domingo, Carmen Ainhoa
A1 Frutos Arribas, Julio Fernando de
A1 Crespo Sedano, Andrea
A1 Cerezo Hernández, Ana
A1 Gutiérrez Tobal, Gonzalo César
A1 Vaquerizo Villar, Fernando
A1 Barroso García, Verónica
A1 Moreno Torrero, Fernando
A1 Ruiz Albi, Tomás
A1 Hornero Sánchez, Roberto
A1 Campo Matias, Félix del
K1 Apnea del sueño
K1 Cardiopatías
K1 Cardiology
K1 Análisis funcional no lineal
K1 Entropía
K1 Ritmo cardíaco - Trastornos
K1 Entropía
K1 32 Ciencias Médicas
K1 3205.01 Cardiología
AB Positional obstructive sleep apnea (POSA) is a major phenotype of sleep apnea. Supine-predominant positional patients are frequently characterized by milder symptoms and less comorbidity due to a lower age, body mass index, and overall apnea-hypopnea index. However, the bradycardia-tachycardia pattern during apneic events is known to be more severe in the supine position, which could affect the cardiac regulation of positional patients. This study aims at characterizing nocturnal heart rate modulation in the presence of POSA in order to assess potential differences between positional and non-positional patients. Patients showing clinical symptoms of suffering from a sleep-related breathing disorder performed unsupervised portable polysomnography (PSG) and simultaneous nocturnal pulse oximetry (NPO) at home. Positional patients were identified according to the Amsterdam POSA classification (APOC) criteria. Pulse rate variability (PRV) recordings from the NPO readings were used to assess overnight cardiac modulation. Conventional cardiac indexes in the time and frequency domains were computed. Additionally, multiscale entropy (MSE) was used to investigate the nonlinear dynamics of the PRV recordings in POSA and non-POSA patients. A total of 129 patients (median age 56.0, interquartile range (IQR) 44.8–63.0 years, median body mass index (BMI) 27.7, IQR 26.0–31.3 kg/m2) were classified as POSA (37 APOC I, 77 APOC II, and 15 APOC III), while 104 subjects (median age 57.5, IQR 49.0–67.0 years, median BMI 29.8, IQR 26.6–34.7 kg/m2) comprised the non-POSA group. Overnight PRV recordings from positional patients showed significantly higher disorderliness than non-positional subjects in the smallest biological scales of the MSE profile (τ = 1: 0.25, IQR 0.20–0.31 vs. 0.22, IQR 0.18–0.27, p < 0.01) (τ = 2: 0.41, IQR 0.34–0.48 vs. 0.37, IQR 0.29–0.42, p < 0.01). According to our findings, nocturnal heart rate regulation is severely affected in POSA patients, suggesting increased cardiac imbalance due to predominant positional apneas.
PB MDPI
SN 1099-4300
YR 2020
FD 2020
LK https://uvadoc.uva.es/handle/10324/58886
UL https://uvadoc.uva.es/handle/10324/58886
LA eng
NO Entropy,  2020, Vol. 22, Nº. 12, 1404
NO Producción Científica
DS UVaDOC
RD 26-dic-2024