Volume 139, Issue 2, Pages (February 2011)

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Volume 139, Issue 2, Pages 253-259 (February 2011) Oximeter-Based Autonomic State Indicator Algorithm for Cardiovascular Risk Assessment Grote Ludger , MD, PhD, Sommermeyer Dirk , MSc, Zou Ding , MD, PhD, Eder Derek N. , PhD, Hedner Jan , MD, PhD CHEST Volume 139, Issue 2, Pages 253-259 (February 2011) DOI: 10.1378/chest.09-3029 Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 1 Study flowchart. ASI = autonomic state indicator; PG = polygraphy; PSG =polysomnography. CHEST 2011 139, 253-259DOI: (10.1378/chest.09-3029) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 2 Neuro-fuzzy system for classification procedure of high-risk patients. CHEST 2011 139, 253-259DOI: (10.1378/chest.09-3029) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 3 Three-minute period of stable non-rapid eye movement sleep without detectable EEG arousal. Please note the variability of both pulse wave amplitude and pulse rate (PR). PPT = pulse propagation time; PWA = pulse wave attenuation; RRPO = respiration-related pulse oscillation; Spo2 = oxygen desaturation. CHEST 2011 139, 253-259DOI: (10.1378/chest.09-3029) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 4 ORs, with 95% CIs, for cardiovascular (CV) risk class progressions over interquartile range spans of each ASI parameter (eg, PPT 200:140). For example, a subject with an Spo2 index of 26 exhibits a 1.7 times (70%) greater risk of being in a higher CV risk class than a subject with an Spo2 index of 4.7. PR.I = pulse rate index; PWA.I = pulse wave attentuation index; Spo2.I = hypoxia index. See Figure 1 and 3 legends for expansion of other abbreviations. CHEST 2011 139, 253-259DOI: (10.1378/chest.09-3029) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 5 A receiver operating characteristic curve showing the sensitivity and specificity of the ASI CV risk score for correct European Society of Hypertension/European Society of Cardiology high CV risk classification in the validation set (n = 49). See Figure 1 and 4 legends for expansion of abbreviations. CHEST 2011 139, 253-259DOI: (10.1378/chest.09-3029) Copyright © 2011 The American College of Chest Physicians Terms and Conditions