TY - JOUR
T1 - Respiratory stress response
T2 - A novel diagnostic method for detection of significant coronary artery disease from finger pulse wave analysis during brief respiratory exercise
AU - Shiyovich, Arthur
AU - Jafari, Jamal
AU - Blaer, Yosi
AU - Rehby, Harvey
AU - Orlov, Ian
AU - Cohen, Dganit
AU - Katz, Amos
PY - 2010/5/1
Y1 - 2010/5/1
N2 - Introduction: Respiratory maneuvers can uncover manifestations of myocardial ischemia. Some pulse wave characteristics are associated with significant coronary artery disease (S-CAD). An innovative test using the respiratory stress response (RSR) has been developed for the detection of S-CAD based on spectral analysis of finger pulse wave oscillations measured using photoplethysmography (PPG) during deep, paced breathing at a rate of 6 breaths per minute (0.1 Hz) for 70 seconds. We evaluated this test (RSR) as an indicator of S-CAD. Methods: The study consisted of 2 stages-feasibility and validation-assessing RSR in patients referred for coronary angiography. RSR was calculated by proprietary software analysis of the relative spectral power of the respiratory peak area at 0.1 Hz. The coronary angiograms were analyzed visually (stage I) and by quantitative coronary angiography (stage II) by 1 cardiologist blinded to the RSR results. S-CAD was defined as luminal stenosis >70% of at least 1 coronary artery or LM stenosis >50%. Results: A total of 193 consecutive patients (stage I: 98 and stage II: 95) with a mean age of 63.2 ± 11.9 years, 70% men, 112 (58%) with S-CAD, were included. S-CAD patients had significantly lower RSR compared with patients without S-CAD, P < 0.001. RSR yielded a sensitivity of 83% (95% confidence interval = 75-90) and specificity of 70% (95% confidence interval = 59-80) for indicating S-CAD. Multivariate logistic regression analysis, adjusted for risk factors, showed that RSR is a strong independent indicator of S-CAD [OR = 18.9 (7.2-49.5), P < 0.001]. Conclusion: Reduced RSR is an accurate noninvasive indicator of S-CAD.
AB - Introduction: Respiratory maneuvers can uncover manifestations of myocardial ischemia. Some pulse wave characteristics are associated with significant coronary artery disease (S-CAD). An innovative test using the respiratory stress response (RSR) has been developed for the detection of S-CAD based on spectral analysis of finger pulse wave oscillations measured using photoplethysmography (PPG) during deep, paced breathing at a rate of 6 breaths per minute (0.1 Hz) for 70 seconds. We evaluated this test (RSR) as an indicator of S-CAD. Methods: The study consisted of 2 stages-feasibility and validation-assessing RSR in patients referred for coronary angiography. RSR was calculated by proprietary software analysis of the relative spectral power of the respiratory peak area at 0.1 Hz. The coronary angiograms were analyzed visually (stage I) and by quantitative coronary angiography (stage II) by 1 cardiologist blinded to the RSR results. S-CAD was defined as luminal stenosis >70% of at least 1 coronary artery or LM stenosis >50%. Results: A total of 193 consecutive patients (stage I: 98 and stage II: 95) with a mean age of 63.2 ± 11.9 years, 70% men, 112 (58%) with S-CAD, were included. S-CAD patients had significantly lower RSR compared with patients without S-CAD, P < 0.001. RSR yielded a sensitivity of 83% (95% confidence interval = 75-90) and specificity of 70% (95% confidence interval = 59-80) for indicating S-CAD. Multivariate logistic regression analysis, adjusted for risk factors, showed that RSR is a strong independent indicator of S-CAD [OR = 18.9 (7.2-49.5), P < 0.001]. Conclusion: Reduced RSR is an accurate noninvasive indicator of S-CAD.
KW - Detection
KW - Respiratory stress response
KW - Significant coronary artery disease
UR - http://www.scopus.com/inward/record.url?scp=77952244580&partnerID=8YFLogxK
U2 - 10.1097/MAJ.0b013e3181d6566a
DO - 10.1097/MAJ.0b013e3181d6566a
M3 - Article
C2 - 20234302
AN - SCOPUS:77952244580
SN - 0002-9629
VL - 339
SP - 440
EP - 447
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 5
ER -