Assessment of baroreflex control from beat‐to‐beat blood pressure and heart rate changes: A validation study

Watkins, Lana L.; Fainman, Claudia; Dimsdale, Joel E.

doi:10.1111/j.1469-8986.1995.tb01224.x

Cited by 35 publications

(34 citation statements)

References 9 publications

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“…The baroreflex nature of sequences has been demonstrated in a previous study, which revealed a dramatic reduction in both up and down sequences after sinoaortic denervation in unanesthetized cats. 26 In accordance with the results of previous studies, 10,27,28 we did not find any difference between the up and down slopes, and the analysis made without separating them made it possible to obtain information on BRS in the whole study population. A significant positive correlation between the sequence method and phenylephrine has been found in healthy subjects 12 and in hypertensive patients.…”

Section: Sequence Analysissupporting

confidence: 91%

“…A significant positive correlation between the sequence method and phenylephrine has been found in healthy subjects 12 and in hypertensive patients. 13 However, Watkins et al 27 have also shown that there are differences between the two methods in subjects with irradiated baroafferents, in whom BRS was found to be reduced only when evaluated by use of the vasoactive drug, despite the good correlation found between the two measurements.…”

Section: Sequence Analysismentioning

confidence: 99%

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Comparison Between Noninvasive Indices of Baroreceptor Sensitivity and the Phenylephrine Method in Post–Myocardial Infarction Patients

et al. 1998

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Background-Depressed baroreflex sensitivity obtained by means of a phenylephrine test plays a prognostic role in patients with a previous myocardial infarction. Our purpose was to evaluate the correlation and agreement between the baroreflex sensitivity obtained with phenylephrine and that obtained by two noninvasive methods: the ␣-index and sequence analysis. Methods and Results-The ␣-index was measured by means of the spectral analysis of RR and systolic blood pressure variabilities in both the high-and low-frequency bands; sequences were identified from simultaneously recorded time series in which the RR and systolic blood pressure concurrently increased or decreased. Noninvasive baroreflex sensitivity tests were performed during both spontaneous and controlled respiration. Fifty-two consecutive patients with recent myocardial infarction underwent the analyses. Although the correlations between phenylephrine and either of the noninvasive methods were always significant, those found during controlled respiration had the highest r values (rϭ.70). However, the limits of agreement calculated by means of the Bland and Altman method were wide for both noninvasive methods. Conclusions-The

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Section: Sequence Analysissupporting

confidence: 91%

Section: Sequence Analysismentioning

confidence: 99%

Comparison Between Noninvasive Indices of Baroreceptor Sensitivity and the Phenylephrine Method in Post–Myocardial Infarction Patients

et al. 1998

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“…It is a physiological technique for the assessment of baroreflex sensitivity at rest that does not require the use of vasoactive drugs with direct effects on afferent, central, or efferent components of the reflex arc [7, 12, 13]. In our study, baroreflex sensitivity obtained by the sequence method at rest significantly correlated with that obtained by the Valsalva maneuver in healthy volunteers and patients with Parkinson’s disease.…”

Section: Discussionsupporting

confidence: 64%

“…Therefore, baroreceptor sensitivity may be evaluated on the basis of fluctuations in blood pressure and associated changes in R–R interval. Several authors have referred to this technique as the sequence method [7, 13, 14]. However, baroreflex sensitivities cannot be measured by the sequence method in some patients with autonomic dysfunction at rest because fluctuations in blood pressure are too small and lack significant correlation with changes in R–R intervals [15].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Baroreflex Sensitivity by the Sequence Method Using Blood Pressure Oscillations and R–R Interval Changes during Deep Respiration

Oka

Mochio²,

Yoshioka³

et al. 2003

Eur Neurol

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Background: Baroreflex sensitivity assessments have been considered to be important to evaluate cardiac autonomic neuropathy. The phenylephrine method, Valsalva maneuver or sequence method at rest caused several problems. We evaluated the usefulness of the sequence method during deep respiration. Method: Baroreflex sensitivity was evaluated in 20 normal volunteers and 50 patients with Parkinson’s disease. R–R intervals and systolic blood pressures were obtained by electrocardiogram and tonometry using a continuous blood pressure monitoring system. The sequence method is an evaluation of baroreflex sensitivity using sequences of 3 or more consecutive beats for 4 min. Baroreflex sensitivity was also assessed by the Valsalva maneuver at 5 beats before the peak systolic blood pressure of phase IV. The slope of the linear interrelationship between systolic blood pressure and the following R–R interval, i.e. baroreflex sensitivity (ms/mm Hg), was calculated with a correlation coefficient greater than 0.8. Result: The mean value of baroreflex sensitivity obtained by the Valsalva maneuver was 7.91 in normal volunteers and 5.35 in patients with Parkinson’s disease; the one obtained by the sequence method at rest was 9.10 in normal volunteers and 8.42 in patients with Parkinson’s disease, and the one obtained by the sequence method during deep respiration was 10.23 in normal volunteers and 6.73 in patients with Parkinson’s disease. In some cases with Parkinson’s disease, baroreflex sensitivities could not be found, whereas in all patients with Parkinson’s disease, the sequence method during deep respiration could be used for evaluations. Significant correlations were found among the baroreflex sensitivities obtained by the Valsalva maneuver, and the sequence method at rest or during deep respiration in normal volunteers and patients with Parkinson’s disease. Conclusions: The baroreflex sensitivity obtained by the sequence method during deep respiration could be investigated noninvasively in all cases with PD, being thus a useful method for clinical evaluation of baroreflex sensitivity.

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“…Because of these issues, a new technique has recently been employed in which arterial baroreflex function is assessed by correlating beat-to-beat fluctuations in arterial pressure with HR, i.e., evaluation of spontaneous baroreflex function (1,2,5,18). A variation of this spontaneous method has also been described (see Ref.…”

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confidence: 99%

Baroreceptor reflex control of heart rate in rats studied by induced and autogenic changes in arterial pressure

Moffitt

Grippo

Johnson

2005

American Journal of Physiology-Heart and Circulatory Physiology

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reflex control of heart rate in rats studied by induced and autogenic changes in arterial pressure. Am J Physiol Heart Circ Physiol 288: H2422-H2430, 2005. First published January 6, 2005; doi:10.1152/ajpheart.00057.2004.-The function of the arterial baroreflex has traditionally been assessed by measurement of reflex changes in heart rate (HR) or sympathetic nerve activity resulting from experimenter-induced manipulation of arterial blood pressure (the Oxford method, also termed the pharmacological method). However, logistical and flexibility limitations of this technique have promoted the development of new methods for assessing baroreflex function such as the evaluation of changes in spontaneous arterial pressure and HR. Although this new spontaneous method has been validated in dogs and humans, it has not been rigorously tested in rats. In the present study, the method of correlating spontaneous changes in systolic blood pressure and HR was evaluated in resting, normotensive Sprague-Dawley rats. This technique was found to be neither reliable nor valid under the conditions employed in the present protocol. We also tested a variation of the spontaneous method that evaluates particular sequences of data during which arterial pressure and pulse interval are changing in the same direction for at least three consecutive heartbeats (the sequence method). The sequence method did not provide extra reliability or validity over the spontaneous method. We conclude that due to the restricted range of variability obtained by measuring spontaneous blood pressure fluctuations, the spontaneous and sequence techniques do not provide data that are comparable to the traditional method of assessing HR changes triggered by arterial blood pressure increases and decreases induced by vasoactive drugs. However, it is possible that surgical stress obscured the relationship between blood pressure and HR, and therefore additional studies are needed to determine whether the spontaneous and sequence methods can be applied to rats during different behavioral states.atropine; phenylephrine; propranolol; reproducibility of results; sodium nitroprusside; validity THE ARTERIAL BARORECEPTOR reflex is a classic negative-feedback mechanism that is essential to maintaining arterial pressure at constant levels. Fluctuations in arterial pressure are sensed by deformation of baroreceptor nerve endings located in the aortic arch and carotid sinus. Through afferent input from baroreceptor neurons and central neural circuitry, parasympathetic and sympathetic activity to the heart as well as sympathetic activity to the vasculature are modulated by changes in arterial pressure. These reflex responses alter cardiac output and peripheral resistance and thus provide compensatory changes in arterial pressure. One means of traditional assessment of baroreceptor reflex function has been the administration of vasoactive drugs to alter arterial pressure and measure resultant changes in heart rate (HR) and sympathetic nerve activity. This pharmacological techniqu...

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Assessment of baroreflex control from beat‐to‐beat blood pressure and heart rate changes: A validation study

Cited by 35 publications

References 9 publications

Comparison Between Noninvasive Indices of Baroreceptor Sensitivity and the Phenylephrine Method in Post–Myocardial Infarction Patients

Comparison Between Noninvasive Indices of Baroreceptor Sensitivity and the Phenylephrine Method in Post–Myocardial Infarction Patients

Evaluation of Baroreflex Sensitivity by the Sequence Method Using Blood Pressure Oscillations and R–R Interval Changes during Deep Respiration

Baroreceptor reflex control of heart rate in rats studied by induced and autogenic changes in arterial pressure

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