Screening for sleep disordered breathing by Holter electrocardiograms

• Project/Area Number: 23591055
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Circulatory organs internal medicine
• Research Institution: Nagoya City University
• Principal Investigator: HAYANO Junichiro 名古屋市立大学, 医学(系)研究科(研究院), 教授 (90173054)
• Project Period (FY): 2011-04-28 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000); Fiscal Year 2013: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2012: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2011: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 睡眠時無呼吸 / ホルター心電図 / 心拍変動 / コンピュータ / 死亡率 / うつ病 / 睡眠 / 心電図 / 心筋梗塞 / 予後予測 / 急性心筋梗塞 / 血液透析 / データベース

Outline of Final Research Achievements

Despite the adverse cardiovascular consequences of sleep disordered breathing (SDB), the majority of patients remain undiagnosed. To establish an effective ECG-based screening tool for SDB, we developed an automated algorithm (ACAT) that detects cyclic variation of heart rate accompanying SDB episodes. Among 862 patients undergoing polysomnographic examination, the ACAT detected moderate-to-severe SDB with 83% sensitivity and 88% specificity. The ACAT also detected SDB patients among 165 apparently healthy track drivers in a transportation company. Furthermore, we applied the ACAT algorithm to Holter ECG recordings in 716 patients after an acute myocardial infarction and found that depression and SDB are interactively associated with increased mortality risk during a median follow-up of 25 months.

Research Products

• [Journal Article] Central sleep apnoea and inflammation are independently associated with arrhythmia in patients with heart failure (2013)
  • Author(s): Sano K, Watanabe E, Hayano J, Mieno Y, Sobue Y, Yamamoto M, Ichikawa T, Sakakibara H, Imaizumi K, Ozaki Y
  • Journal Title: Eur J Heart Fail Volume: 15 Issue: 9 Pages: 1003-1010
  • DOI: 10.1093/eurjhf/hft066
  • Peer Reviewed
• [Journal Article] Heart rate variability biofeedback improves cardiorespiratory resting function during sleep (2013)
  • Author(s): Sakakibara M, Hayano J, Oikawa LO, Katsamanis M, Lehrer P
  • Journal Title: Appl Psychophysiol Biofeedback Volume: 38 Pages: 265-271
  • Peer Reviewed
• [Journal Article] Site-specific organ-selective effect of epifascial acupuncture on cardiac and gastric autonomic functions (2013)
  • Author(s): Minagawa M, Kurono Y, Ishigami T, Yamada A, Kakamu T, Akai R, Hayano J
  • Journal Title: Auton Neurosci Volume: 179 Issue: 1-2 Pages: 151-154
  • DOI: 10.1016/j.autneu.2013.03.005
  • Peer Reviewed
• [Journal Article] Multi-scale heart rate dynamics detected by phase-rectified signal averaging predicts mortality after acute myocardial infarction. (2013)
  • Author(s): Kisohara M, Stein PK, Yoshida Y, Suzuki M, Iizuka N, Carney RM, Watkins LL, Freedland KE, Blumenthal JA, Hayano J.
  • Journal Title: Europace Volume: 15 Issue: 3 Pages: 437-443
  • DOI: 10.1093/europace/eus409
  • Peer Reviewed
• [Journal Article] Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company. (2013)
  • Author(s): Hayano J, Tsukahara T, Watanabe E, Sasaki F, Kawai K, Sakakibara H, Kodama I, Nomiyama T, Fujimoto K.
  • Journal Title: Sleep Breath Volume: 17 Issue: 1 Pages: 243-251
  • DOI: 10.1007/s11325-012-0681-7
  • Peer Reviewed
• [Journal Article] Effect of obstructive sleep apnea on response to cognitive behavior therapy for depression after an acute myocardial infarction. (2012)
  • Author(s): Freedland KE, Carney RM, Hayano J, Steinmeyer BC, Reese RL, Roest AM
  • Journal Title: J Psychosom Res Volume: 72 Issue: 4 Pages: 276-281
  • DOI: 10.1016/j.jpsychores.2011.12.012
  • Peer Reviewed
• [Journal Article] Nonlinear measures of heart rate variability and mortality risk in hemodialysis patients. (2012)
  • Author(s): Suzuki M, Hiroshi T, Aoyama T, Tanaka M, Ishii H, Kisohara M, Iizuka N, Murohara T, Hayano J.
  • Journal Title: Clin J Am Soc Nephrol Volume: 7 Issue: 9 Pages: 1454-1460
  • DOI: 10.2215/cjn.09430911
  • Peer Reviewed
• [Journal Article] Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company (2012)
  • Author(s): Junichiro Hayano
  • Journal Title: Sleep Breath Volume: Mar 20
  • Peer Reviewed
• [Journal Article] Effect of obstructive sleep apnea on response to cognitive behavior therapy for depression after an acute myocardial infarction (2012)
  • Author(s): Keneth E. Freedland
  • Journal Title: J Psychosom Res Volume: 72 Pages: 276-281
  • Peer Reviewed
• [Journal Article] Non-gaussianity of low frequency heart rate variability and sympathetic activation: lack of increases in multiple system atrophy and Parkinson disease. (2012)
  • Author(s): Ken Kiyono
  • Journal Title: Front Physiol Volume: 3 Pages: 34-34
  • Peer Reviewed
• [Journal Article] Diagnosis of sleep apnea by the analysis of heart rate variation: a mini review (2011)
  • Author(s): Junichiro Hayano
  • Journal Title: Conf Proc IEEE Eng Med Biol Soc Volume: 2011 Pages: 7731-7734
• [Journal Article] Increased non-gaussianity of heart rate variability predicts cardiac mortality after an acute myocardial infarction (2011)
  • Author(s): Junichiro Hayano
  • Journal Title: Front Physiol Volume: 2 Pages: 65-65
  • Peer Reviewed
• [Presentation] Increased Mortality Risk in Patients with Blunted Cyclic Variation of Heart Rate in Nighttime ECG (2015)
  • Author(s): Junichiro Hayano, Fumihiko Yasuma, Robert M. Carney, Phyllis K. Stein, James A. Blumenthal, Petros Arsenos, Konstantinos A. Gatzoulis, Hiroshi Takahashi, Hideki Ishii, Eiichi Watanabe
  • Organizer: Congress of the International Society for Holter and Noninvasive Electrocardiology
  • Place of Presentation: Lyon, France
  • Year and Date: 2015-06-04 – 2015-06-06
• [Presentation] Long-time-scale heart rate dynamics detected by phase-rectified signal averaging predicts mortality after acute myocardial infarction (2012)
  • Author(s): Kisohara Masaya
  • Organizer: American College of Cardiology
  • Place of Presentation: シカゴ、米国
• [Patent(Industrial Property Rights)] CVHR形状測定装置 (2015)
  • Inventor(s): 早野順一郎
  • Industrial Property Rights Holder: 早野順一郎
  • Industrial Property Rights Type: 特許
  • Industrial Property Number: 2015-049863
  • Filing Date: 2015-03-12