Published online before print September 15, 2003, doi: 10.1161/01.HYP.0000091370.83602.E6
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2003;42:481.)
© 2003 American Heart Association, Inc.
Scientific Contributions |
Spontaneous Indices Are Inconsistent With Arterial Baroreflex Gain
From the Laboratories for Cardiovascular Research, Hebrew Rehabilitation Center for Aged Research and Training Institute (R.D.L., J.K.S., J.A.T.), and the Division on Aging, Harvard Medical School (R.D.L., J.A.T.), Boston, Mass.
Correspondence to J. Andrew Taylor, PhD, Director, HRCA Laboratories for Cardiovascular Research, 1200 Centre St, Boston, MA 02131. E-mail ataylor{at}mail.hrca.harvard.edu
Spontaneously occurring, parallel fluctuations in arterial pressure and heart period are frequently used as indices of baroreflex function. Despite the convenience of spontaneous indices, their relation to the arterial baroreflex remains unclear. Therefore, in 97 volunteers, we derived 5 proposed indices (sequence method, 
-index, transfer function, low-frequency transfer function, and impulse response function), compared them with arterial baroreflex gain (by the modified Oxford pharmacologic technique), and examined their relation to carotid distensibility and respiratory sinus arrhythmia. The subjects comprised men and women (n=41) aged 25 to 86 years, 30% of whom had established coronary artery disease. Generally, the indices were correlated with each other (except -index and low-frequency transfer function) and with baroreflex gain. However, the Bland-Altman method demonstrated that the spontaneous indices had limits of agreement as large as the baroreflex gain itself. Even in individuals within the lowest tertile of baroreflex gain for whom baroreflex gain appears to be the most clinically relevant, spontaneous indices failed to relate to baroreflex gain. In fact, for these individuals, there was no correlation between any index and baroreflex gain. Forward stepwise linear regression showed that all spontaneous indices and baroreflex gain were related to respiratory sinus arrhythmia, but only baroreflex gain was related to carotid distensibility. Therefore, these data suggest that spontaneous indices are inadequate estimates of gain and are inconsistent with arterial baroreflex function.
Key Words: baroreceptors • carotid sinus • elasticity • arrhythmia • baroreflex
This article has been cited by other articles:
 |
|
 |
|
  Y. C. Tzeng, P. Y. W. Sin, S. J. E. Lucas, and P. N. Ainslie Respiratory modulation of cardiovagal baroreflex sensitivity J Appl Physiol, September 1, 2009; 107(3): 718 - 724. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. M. Pulgar, J. K.-s. Hong, J. A. Jessup, A. G. Massmann, D. I. Diz, and J. P. Figueroa Mild chronic hypoxemia modifies expression of brain stem angiotensin peptide receptors and reflex responses in fetal sheep Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2009; 297(2): R446 - R452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Deley, G. Picard, and J. A. Taylor Arterial Baroreflex Control of Cardiac Vagal Outflow in Older Individuals Can Be Enhanced by Aerobic Exercise Training Hypertension, May 1, 2009; 53(5): 826 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Fisher, S. Ogoh, C. Junor, A. Khaja, M. Northrup, and P. J. Fadel Spontaneous baroreflex measures are unable to detect age-related impairments in cardiac baroreflex function during dynamic exercise in humans Exp Physiol, April 1, 2009; 94(4): 447 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Deley, R. D. Lipman, J. P. Kannam, C. Bartolini, and J. A. Taylor Stress responses and baroreflex function in coronary disease J Appl Physiol, February 1, 2009; 106(2): 576 - 581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. E. Lucas, J. D. Cotter, C. Murrell, L. Wilson, J. G. Anson, D. Gaze, K. P. George, and P. N. Ainslie Mechanisms of orthostatic intolerance following very prolonged exercise J Appl Physiol, July 1, 2008; 105(1): 213 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Murrell, L. Wilson, J. D. Cotter, S. Lucas, S. Ogoh, K. George, and P. N. Ainslie Alterations in autonomic function and cerebral hemodynamics to orthostatic challenge following a mountain marathon J Appl Physiol, July 1, 2007; 103(1): 88 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Berteotti, V. Asti, V. Ferrari, C. Franzini, P. Lenzi, G. Zoccoli, and A. Silvani Central and baroreflex control of heart period during the wake-sleep cycle in spontaneously hypertensive rats Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2007; 293(1): R293 - R298. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. E. Westerhof, J. Gisolf, J. M. Karemaker, K. H. Wesseling, N. H. Secher, and J. J. van Lieshout Time course analysis of baroreflex sensitivity during postural stress Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2864 - H2874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Malliani, C. Julien, G. E. Billman, S. Cerutti, M. F. Piepoli, L. Bernardi, P. Sleight, M. A. Cohen, C. O. Tan, D. Laude, et al. Cardiovascular variability is/is not an index of autonomic control of circulation J Appl Physiol, August 1, 2006; 101(2): 684 - 688. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Wenner, A. V. Prettyman, R. E. Maser, and W. B. Farquhar Preserved autonomic function in amenorrheic athletes J Appl Physiol, August 1, 2006; 101(2): 590 - 597. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.-S. Hwang, Y.-K. Kim, I.-Y. Huh, and S.-J. Kang Assessing arterial baroreflex control of heart rate during general anesthesia. Anesth. Analg., April 1, 2006; 102(4): 1288 - 1288. [Full Text] [PDF]
|
|
|
|
|
|
S. Masuki, J. H. Eisenach, F. A. Dinenno, and M. J. Joyner Reduced forearm {alpha}1-adrenergic vasoconstriction is associated with enhanced heart rate fluctuations in humans J Appl Physiol, March 1, 2006; 100(3): 792 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Lipsitz, I. Iloputaife, M. Gagnon, D. K. Kiely, and J. M. Serrador Enhanced Vasoreactivity and Its Response to Antihypertensive Therapy in Hypertensive Elderly Women Hypertension, March 1, 2006; 47(3): 377 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Steinback, D. D. O'Leary, J. Bakker, A. D. Cechetto, H. M. Ladak, and J. K. Shoemaker Carotid distensibility, baroreflex sensitivity, and orthostatic stress J Appl Physiol, July 1, 2005; 99(1): 64 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tanaka and T. Nishikawa The Concentration-Dependent Effects of General Anesthesia on Spontaneous Baroreflex Indices and Their Correlations with Pharmacological Gains Anesth. Analg., May 1, 2005; 100(5): 1325 - 1332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Gulli, V. E. Claydon, V. L. Cooper, and R. Hainsworth R-R interval-blood pressure interaction in subjects with different tolerances to orthostatic stress Exp Physiol, May 1, 2005; 90(3): 367 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. E. Hunt and W. B. Farquhar Nonlinearities and asymmetries of the human cardiovagal baroreflex Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2005; 288(5): R1339 - R1346. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Nollo, L. Faes, A. Porta, R. Antolini, and F. Ravelli Exploring directionality in spontaneous heart period and systolic pressure variability interactions in humans: implications in the evaluation of baroreflex gain Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1777 - H1785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Carrington, R. Barbieri, I. M. Colrain, K. E. Crowley, Y. Kim, and J. Trinder Changes in cardiovascular function during the sleep onset period in young adults J Appl Physiol, February 1, 2005; 98(2): 468 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C. R. Dias, M. Vitela, E. Colombari, and S. W. Mifflin Nitric oxide modulation of glutamatergic, baroreflex, and cardiopulmonary transmission in the nucleus of the solitary tract Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H256 - H262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Lenard, P. Studinger, B. Mersich, L. Kocsis, and M. Kollai Maturation of Cardiovagal Autonomic Function From Childhood to Young Adult Age Circulation, October 19, 2004; 110(16): 2307 - 2312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tanaka, T. Goyagi, T. Kimura, and T. Nishikawa The Effects of Cervical and Lumbar Epidural Anesthesia on Heart Rate Variability and Spontaneous Sequence Baroreflex Sensitivity Anesth. Analg., September 1, 2004; 99(3): 924 - 929. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Parati, M. Di Rienzo, P. Castiglioni, M. Bouhaddi, C. Cerutti, A. Cividjian, J.-L. Elghozi, J.-O. Fortrat, A. Girard, B. J.A. Janssen, et al. Assessing the Sensitivity of Spontaneous Baroreflex Control of the Heart: Deeper Insight Into Complex Physiology * Response Hypertension, May 1, 2004; 43(5): e32 - e34. [Full Text] [PDF]
|
|
|
|
|
|
A. Malliani, N. Montano, R. D. Lipman, and J. A. Taylor Gold Standard in Assessing Baroreceptive Function * Response: Gold Standards for Baroreflex Gain Hypertension, April 1, 2004; 43(4): e24 - e24. [Full Text] [PDF]
|
|