Journal
CHEST
Volume 140, Issue 5, Pages 1192-1197Publisher
AMER COLL CHEST PHYSICIANS
DOI: 10.1378/chest.10-2625
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Funding
- American Heart Association [09-20069G]
- Mayo Clinic
- National Institutes of Health (NIH) [HL65176, 1 UL1 RR024150, HL09953]
- IGA of Ministry of Health [NS 10098-4/2008]
- European Regional Development Fund [CZ.1.05/1.1.00/02.0123]
- Respironics Foundation for Sleep and Breathing
- ResMed Foundation
- Respironics Sleep and Respiratory Research Foundation
- Sorin, Inc
- Select Research, Inc
- National Center for Research Resources (NCRR), a component of NIH [1 UL1 RR024150]
- NIH Roadmap for Medical Research
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Background: The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI. Methods: We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the gold standard. SDB was defined as an apnea-hypopnea index of >= 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated. Results: Of the 99 patients, the BQ identified 64 (65%) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73%) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63%. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results. Conclusion: The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI. CHEST 2011; 140(5):1192-1197
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