Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis

Younghoon Kwon, Sara Mariani, Michelle Reid, David Jacobs, Joao Lima, Vishesh Kapur, Naresh Punjabi, Susan Redline

Research output: Contribution to journalArticlepeer-review


Background: Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods: We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results: Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions: In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.

Original languageEnglish (US)
Pages (from-to)8-11
Number of pages4
JournalSleep Medicine
StatePublished - Nov 2020

Bibliographical note

Funding Information:
This work was supported by N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the NHBLI , by grants UL1-TR-000040 , UL1-RR-025005 from NCRR , R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication.


  • Atherosclerosis
  • Cardiovascular
  • Circulation
  • Coronary artery calcium
  • Polysomnography
  • Sleep apnea

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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