The importance of high-frequency paced breathing in spectral baroreflex sensitivity assessment

Frederiks, J.; Swenne, Cees A.; TenVoorde, Ben J.; Honzíková, Nataša; Levert, J.V.; Maan, Arie C.; Schalij, Martin J.; Bruschke, Albert V.G.

doi:10.1097/00004872-200018110-00015

Cited by 64 publications

(52 citation statements)

References 33 publications

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“…Measuring the transfer function in the LF band would imply that false mechanical influences of respiration would be discarded, provided that respiration was not in the LF band. Spontaneous respiration is not always regular, and to ensure that respiration is in the HF band, it is useful to instruct the subjects to breathe in a fixed rate, e.g., at 0.25 Hz and guided by a respiration metronome computer screen [10].…”

Section: Algorithms In the Time And Frequency Domainmentioning

confidence: 99%

Baroreflex sensitivity: mechanisms and measurement

Swenne

2012

Neth Heart J

112

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This article is a brief review of baroreflex physiology, the definition and functional meaning of baroreflex sensitivity, and the methods used to measure baroreflex sensitivity. The arterial baroreflex is important for haemodynamic stability and for cardioprotection, and it has convincingly been demonstrated that baroreflex sensitivity, even when assessed with different methods, has a strong prognostic value. Development of new baroreflex assessing procedures is still ongoing, with a focus on increased reliability in difficult measuring circumstances, e.g., in patients with a weak baroreflex and in patients with frequent arrhythmias.

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Section: Algorithms In the Time And Frequency Domainmentioning

confidence: 99%

Baroreflex sensitivity: mechanisms and measurement

Swenne

2012

Neth Heart J

112

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“…Moreover, in subjects with a regular breathing activity within the HF band, the respiratory frequency is characterized by a marked variability both between and within individuals (15). Because the transfer between respiratory oscillations and cardiovascular signals is a frequency-dependent phenomenon (6,7,14,31), this variability would likely translate into variability of HF spectral parameters.Therefore, voluntary control of respiration at frequencies Ն0.2 Hz has been advocated as a means to avoid confounding and to standardize measurements in short-term evaluations of autonomic cardiovascular rhythms (6,7,10,31,32,36). This procedure would also improve the reproducibility of some spectral parameters (30).…”

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confidence: 99%

“…Therefore, voluntary control of respiration at frequencies Ն0.2 Hz has been advocated as a means to avoid confounding and to standardize measurements in short-term evaluations of autonomic cardiovascular rhythms (6,7,10,31,32,36). This procedure would also improve the reproducibility of some spectral parameters (30).…”

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confidence: 99%

Effect of paced breathing on ventilatory and cardiovascular variability parameters during short-term investigations of autonomic function

Pinna

Maestri

Rovere

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

100

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25 Hz has been advocated as a means to avoid confounding and to standardize measurements in short-term investigations of autonomic cardiovascular regulation. Controversy remains, however, as to whether it causes any alteration in autonomic control. We addressed this issue in 40 supine, middle-aged, healthy volunteers by assessing the changes induced by PB (0.25 Hz for 8 min) on 1) ventilatory parameters, 2) the indexes of autonomic control of cardiovascular function, and 3) the spectral indexes of cardiovascular variability. Subjects were grouped into group 1 (n ϭ 31), if spontaneous breathing was regular and within the high-frequency (HF) band (0.15-0.45 Hz), or group 2 (n ϭ 9), if it was irregular or slow (Ͻ0.15 Hz). In both groups, PB was accompanied by an increase in minute ventilation (both groups, P Ͻ 0.01), whereas tidal volume increased only in group 1 (P ϭ 0.0003). End-tidal CO 2 decreased by [median (lower quartile, upper quartile)] Ϫ0.2 (Ϫ0.5, Ϫ0.1)% (group 1, P Ͻ 0.0001) and Ϫ0.6 (Ϫ0.8, Ϫ0.5)% (group 2, P ϭ 0.008). Mean R-R interval and systolic and diastolic pressure remained remarkably stable (all P Ն 0.13, both groups). No significant changes were observed in spectral indexes of R-R and pressure variability (all P Ն 0.12, measured only in group 1 to avoid confounding), except in the HF power of pressure signals, which significantly increased (all P Ͻ 0.05) in association with increased tidal volume. In conclusion, PB at 0.25 Hz causes a slight hyperventilation and does not affect traditional indexes of autonomic control or, in subjects with spontaneous breathing in the HF band, most relevant spectral indexes of cardiovascular variability. These findings support the notion that PB does not alter cardiovascular autonomic regulation compared with spontaneous breathing.heart rate variability; controlled breathing; baroreflex sensitivity; spectral analysis A LARGE NUMBER OF STUDIES (9,19,35) have been published in the last two decades using the analysis of spontaneous oscillations of pulse interval and blood pressure as an indirect, quantitative, and noninvasive means to assess the autonomic control of cardiovascular function. Both physiopathological investigations and clinical applications have been carried out, and a rich variety of algorithms for analysis have been proposed. Among them, those based on spectral analysis of individual signals and of their mutual interrelationships have gained the highest interest, mainly because they would enable an interpretative link between different oscillatory components and specific physiological mechanisms (18,23,37). To control for confounding factors that might affect measured parameters, cardiovascular variability signals have been mostly collected during short-term recordings performed in dedicated laboratories, where environmental and physical conditions have been kept constant and emotional and sensorial stimuli have been avoided. Less attention, however, has been paid to respiration, despite much evidence that breathing characteristics (frequency, amplit...

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“…BRS was computed as the averaged magnitude of TF in the low-frequency (LF, 0.05-0.15 Hz) band (15,37,39). This band incorporates the Mayer frequencies.…”

Section: Main Derived Simulation Variables: Brs Sbp-buffering Capacimentioning

confidence: 99%

“…There are two reasons to be skeptical in this respect: 1) by definitioninterbeat interval change per unit blood pressure change-BRS is bound to characterize baroreflex-mediated effects on the heart, while the baroreflex buffers blood pressure mainly by controlling peripheral resistance (2,30); and 2) oftentimes being assessed in the Mayer frequency range of spontaneous heart rate and blood pressure fluctuations (15,39), BRS might represent resonance rather than buffering baroreflex characteristics.…”

mentioning

confidence: 99%

Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients

Vooren

Gademan²,

Swenne

et al. 2007

Journal of Applied Physiology

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Van de Vooren H, Gademan MG, Swenne CA, TenVoorde BJ, Schalij MJ, Van der Wall EE. Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients. J Appl Physiol 102: 1348 -1356, 2007. First published December 21, 2006; doi:10.1152/japplphysiol.00158.2006.-The arterial baroreflex buffers slow (Ͻ0.05 Hz) blood pressure (BP) fluctuations, mainly by controlling peripheral resistance. Baroreflex sensitivity (BRS), an important characteristic of baroreflex control, is often noninvasively assessed by relating heart rate (HR) fluctuations to BP fluctuations; more specifically, spectral BRS assessment techniques focus on the BP-to-HR transfer function around 0.1 Hz. Skepticism about the relevance of BRS to characterize baroreflex-mediated BP buffering is based on two considerations: 1) baroreflex-modulated peripheral vasomotor function is not necessarily related to baroreflex-HR transfer; and 2) although BP fluctuations around 0.1 Hz (Mayer waves) might be related to baroreflex BP buffering, they are merely a not-intended side effect of a closed-loop control system. To further investigate the relationship between BRS and baroreflex-mediated BP buffering, we set up a computer model of baroreflex BP control to simulate normal subjects and heart failure patients. Output variables for various randomly chosen combinations of feedback gains in the baroreflex arms were BP resonance, BP-buffering capacity, and BRS. Our results show that BP buffering and BP resonance are related expressions of baroreflex BP control and depend strongly on the sympathetic gain to the peripheral resistance. BRS is almost uniquely determined by the vagal baroreflex gain to the sinus node. In conclusion, BP buffering and BRS are unrelated unless coupled gains in all baroreflex limbs are assumed. Hence, the clinical benefit of a high BRS is most likely to be attributed to vagal effects on the heart instead of to effective BP buffering. autonomic nervous system; cardiovascular variability; Mayer waves; spectral analysis; transfer function IN DAILY LIFE, multiple processes perturb blood pressure. The duration of these challenges varies widely. For example, respiration makes blood pressure fluctuate with every breath (13), while physical or mental stress elevates blood pressure for minutes or even longer. The arterial baroreflex is a negativefeedback mechanism that effectively buffers such incidental blood pressure fluctuations (11,20,21,23). In negativefeedback systems, feedback delay often causes resonance in a given frequency band; this is the price to be paid for effective buffering at other frequencies. Resonance in blood pressure (5,8,12,31,49) manifests in the form of the well-known Mayer (22, 33) waves (beat-to-beat blood pressure oscillations with a frequency of ϳ0.1 Hz/period of ϳ10 s). Effective baroreflex blood pressure buffering occurs below the Mayer frequency (10, 16).Besides a sympathetic limb that modulates peripheral resistance, the baroreflex has ...

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The importance of high-frequency paced breathing in spectral baroreflex sensitivity assessment

Cited by 64 publications

References 33 publications

Baroreflex sensitivity: mechanisms and measurement

Baroreflex sensitivity: mechanisms and measurement

Effect of paced breathing on ventilatory and cardiovascular variability parameters during short-term investigations of autonomic function

Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients

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