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Diagnostic Decision Support of Heart Rate Turbulence in Sleep Apnea Syndrome

机译：睡眠呼吸暂停综合征心率紊乱的诊断决策支持

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Obstructive sleep apnea syndrome (OSAS) is characterized by repeated upper-airway obstruction during sleep. It is diagnosed by polysomnographic studies, scoring OSAS severity by an apneas/hypopneas index associated to worse prognosis, mainly for an increased cardiovascular morbidity. Cardiac autonomic impairments involved in the development of cardiovascular disease in OSAS can be assessed by heart rate turbulence (HRT) analysis and aim of the paper is to show the increased medical decision support by HRT evaluation in OSAS patients. HRT has been assessed in 274 polysomnographic recordings of mild-to-severe OSAS patients and an overall cardiorespiratory risk scoring (CRRIS) index has been proposed on the base of both OSAS severity and HRT assessment. Results showed that, while the only polysomnografic analysis would have equally ranked OSAS patients within their mild-to-severe classification, CRRIS index allows to identify a 19% of severe-OS AS patients at very high risk of sudden cardiac death, a 13% of moderate-OSAS patients with a risk level comparable to those of severe, and a 17% of mild-OSAS patients with evidence of an autonomic impairment. CRRIS index, detecting patients at greater probability of worsening could give to the physician a very useful medical decision support in the follow up of this particular chronic disease.
机译：阻塞性睡眠呼吸暂停综合症（OSAS）的特征是睡眠期间反复出现上呼吸道阻塞。它是由多导睡眠图检查法诊断的，通过与预后较差有关的呼吸暂停/呼吸不足指数对OSAS严重程度进行评分，主要是因为心血管疾病的发病率增加。可以通过心率湍流（HRT）分析来评估OSAS中与心血管疾病发展相关的心脏自主神经功能障碍，本文的目的是通过ORT患者中的HRT评估来显示增加的医学决策支持。在274例轻度至重度OSAS患者的多导睡眠图记录中对HRT进行了评估，并已基于OSAS严重程度和HRT评估提出了总体心肺风险评分（CRRIS）指数。结果表明，尽管唯一的多器官移植分析法可以将OSAS患者在轻度至重度分类中均等地排名，但CRRIS指数可以识别出19％的严重OS AS患者具有极高的心脏猝死风险，而13％的中度OSAS患者的风险水平可与重度OSAS相媲美，而17％的轻度OSAS患者具有自主神经功能减退的证据。通过CRRIS指数，发现患者恶化的可能性更大，可以为医生提供对这一特定慢性疾病进行随访的非常有用的医学决策支持。

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