Thomas RJ, Weiss MD, Mietus JE, et al. Prevalent hypertension and stroke in the Sleep Heart Health Study: association with an ECG-derived spectrographic marker of cardiopulmonary coupling. Sleep 2009; 32(7): 897-904. PMID: 19639752 PMCID: PMC2706909
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.
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.