Advanced analysis of spontaneous baroreflex sensitivity, blood pressure and heart rate variability in patients with dilated cardiomyopathy

2002 ◽  
Vol 102 (4) ◽  
pp. 465 ◽  
Author(s):  
Hagen MALBERG ◽  
Niels WESSEL ◽  
Annett HASART ◽  
Karl-Josef OSTERZIEL ◽  
Andreas VOSS
2002 ◽  
Vol 102 (4) ◽  
pp. 465-473 ◽  
Author(s):  
Hagen MALBERG ◽  
Niels WESSEL ◽  
Annett HASART ◽  
Karl-Josef OSTERZIEL ◽  
Andreas VOSS

Baroreflex sensitivity (BRS) is an important parameter in the classification of patients with reduced left ventricular function. This study aimed at investigating BRS in patients with dilated cardiomyopathy (DCM) and in healthy subjects (controls), as well as comparing the values of BRS parameters with parameters of heart rate variability (HRV) and blood pressure variability (BPV). ECG, continuous blood pressure and respiration curves were recorded for 30min in 27 DCM patients and 27 control subjects. The Dual Sequence Method (DSM) includes the analysis of spontaneous fluctuations in systolic blood pressure and the corresponding beat-to-beat intervals of heart rate to estimate bradycardic, opposite tachycardic and delayed baroreflex fluctuations. The number of systolic blood pressure/beat-to-beat interval fluctuations in DCM patients was reduced in comparison with controls (DCM patients: male, 154.4±93.9ms/mmHg; female, 93.7±40.5ms/mmHg; controls: male, 245.5±112.9ms/mmHg; female, 150.6±55.8ms/mmHg, P < 0.05). The average slope in DCM patients was lower than in controls (DCM, 5.3±1.9ms/mmHg; controls, 8.0±5.4ms/mmHg; P < 0.05). Discriminant function analysis showed that, in the synchronous range of the standard sequence method, the DCM and control groups could be discriminated to only 76% accuracy, whereas the DSM gave an improved accuracy of 84%. The combination of six parameters of HRV, BPV and DSM gives an accuracy of classification of 96%, whereas six parameters of HRV and BPV could separate the two groups to only 88% accuracy. Thus the DSM leads to an improved characterization of autonomous regulation in order to differentiate between DCM patients and healthy subjects. BRS in DCM patients is significantly reduced and apparently less effective.


2020 ◽  
Vol 30 (5) ◽  
pp. 433-439 ◽  
Author(s):  
Priyanka Garg ◽  
Kavita Yadav ◽  
Ashok Kumar Jaryal ◽  
Garima Kachhawa ◽  
Alka Kriplani ◽  
...  

2006 ◽  
Vol 16 (5) ◽  
pp. 412-417 ◽  
Author(s):  
Mathias Baumert ◽  
Lars Brechtel ◽  
J??rgen Lock ◽  
Mario Hermsdorf ◽  
Roland Wolff ◽  
...  

1998 ◽  
Vol 21 (11) ◽  
pp. 2416-2419 ◽  
Author(s):  
VOLKER MENZ ◽  
WOLFRAM GRIMM ◽  
JUIRGEN HOFFMANN ◽  
STEPHAN BORN ◽  
CHRISTINA SCHMIDT ◽  
...  

2011 ◽  
Vol 301 (4) ◽  
pp. H1540-H1550 ◽  
Author(s):  
Megan S. Johnson ◽  
Vincent G. DeMarco ◽  
Cheryl M. Heesch ◽  
Adam T. Whaley-Connell ◽  
Rebecca I. Schneider ◽  
...  

The aim of this investigation was to evaluate sex differences in baroreflex and heart rate variability (HRV) dysfunction and indexes of end-organ damage in the TG(mRen2)27 (Ren2) rat, a model of renin overexpression and tissue renin-angiotensin-aldosterone system overactivation. Blood pressure (via telemetric monitoring), blood pressure variability [BPV; SD of systolic blood pressure (SBP)], spontaneous baroreflex sensitivity, HRV [HRV Triangular Index (HRV-TI), standard deviation of the average NN interval (SDNN), low and high frequency power (LF and HF, respectively), and Poincaré plot analysis (SD1, SD2)], and cardiovascular function (pressure-volume loop analysis and proteinuria) were evaluated in male and female 10-wk-old Ren2 and Sprague Dawley rats. The severity of hypertension was greater in Ren2 males (R2-M) than in Ren2 females (R2-F). Increased BPV, suppression of baroreflex gain, decreased HRV, and associated end-organ damage manifested as cardiac dysfunction, myocardial remodeling, elevated proteinuria, and tissue oxidative stress were more pronounced in R2-M compared with R2-F. During the dark cycle, HRV-TI and SDNN were negatively correlated with SBP within R2-M and positively correlated within R2-F; within R2-M, these indexes were also negatively correlated with end-organ damage [left ventricular hypertrophy (LVH)]. Furthermore, within R2-M only, LVH was strongly correlated with indexes of HRV representing predominantly vagal (HF, SD1), but not sympathetic (LF, SD2), variability. These data demonstrated relative protection in females from autonomic dysfunction and end-organ damage associated with elevated blood pressure in the Ren2 model of hypertension.


2003 ◽  
Vol 81 (9) ◽  
pp. 894-902 ◽  
Author(s):  
C Ann Brown ◽  
Larry A Wolfe ◽  
Sylvia Hains ◽  
Glorianne Ropchan ◽  
Joel Parlow

The effects of coronary artery bypass graft (CABG) surgery on spontaneous baroreflex (SBR) sensitivity and heart rate variability were examined in 11 women and 23 men preoperatively and 5 days postoperatively. Electrocardiograph R–R interval and beat-by-beat arterial blood pressure data were collected continuously for 20 min in the supine and standing postures. Coarse graining spectral analysis was performed on the heart rate variability data. Spontaneous baroreflex sensitivity declined after surgery with a differential influence of gender. Men showed a decrease in SBR slope following surgery, with a greater decrease in the standing posture; the parasympathetic (PNS) indicator was lower postoperatively and in the standing posture; the reduction in low-frequency (LF) power was greater for the younger men. In women, the PNS indicator was lower in the standing posture. Both men and women showed a decrease in high-frequency power following CABG surgery, which decreased the sensitivity of the short-term cardiac control mechanisms that modulate heart rate, with the greater effects occurring in men. The reduction in SBR sensitivity indicates that the ability of the cardiovascular system to respond rapidly to changing stimuli was compromised. The decline in the PNS indicator implies that patients were vulnerable to the risks of myocardial ischemia, sympathetically mediated cardiac dysrhythmias, and sudden cardiac death.Key words: spectral analysis, spontaneous baroreflex sensitivity, CABG surgery, gender, age, posture.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A177-A177
Author(s):  
H Tsai ◽  
T Kuo ◽  
C Yang

Abstract Introduction Insomnia is a risk factor for hypertension and cardiovascular events, and this association is strongest for sleep-onset insomnia. However, little is known about insomnia on cardiovascular modulation, especially soon after morning awakening, the peak period of time for cardiovascular incidents. This study explored morning cardiovascular function in individuals with sleep-onset insomnia by analysing heart rate variability, blood pressure variability, and baroreflex sensitivity. Methods Sleep structure of the participants (15 good sleepers and 13 individuals with sleep-onset insomnia) was measured by laboratory polysomnography, followed by continuous recordings of the participant’s blood pressure and heart rate for 10 min in the morning. Results When compared to the good sleepers, the insomnia group showed significant reductions in total sleep time, a longer sleep-onset latency, and reduced sleep efficiency. The sleep structure, including durations of sleep stages, numbers of awakenings and arousal index did not differ between the groups. After morning awakening (averaged time: 12.33 ± 10.48 min), the shorter R-R intervals, lower total power, and lower high-frequency power of heart rate variability were observed among individuals with sleep-onset insomnia, compared with good sleepers. Elevated slopes of systolic and diastolic blood pressure, as well as lower baroreflex sensitivity, were also shown in the insomnia group. Indices of sympathetic activity, including low-frequency percentage of heart rate variability or low-frequency power of blood pressure variability, did not differ between the groups. Conclusion Weak vagal activity and blunted baroreflex sensitivity were evident among sleep-onset insomnia. These findings indicate difficulty in initiating sleep, without significant sleep fragmentation, can independently affect morning cardiovascular function. This study provides a possible link between sleep-onset insomnia and risk of cardiovascular events. Support N/A


2019 ◽  
Vol 33 (1) ◽  
pp. 39-53 ◽  
Author(s):  
Stefan Duschek ◽  
Alexandra Hoffmann ◽  
Casandra I. Montoro ◽  
Gustavo A. Reyes del Paso

Abstract. Chronic low blood pressure (hypotension) is accompanied by symptoms such as fatigue, reduced drive, faintness, dizziness, cold limbs, and concentration difficulties. The study explored the involvement of aberrances in autonomic cardiovascular control in the origin of this condition. In 40 hypotensive and 40 normotensive subjects, impedance cardiography, electrocardiography, and continuous blood pressure recordings were performed at rest and during stress induced by mental calculation. Parameters of cardiac sympathetic control (i.e., stroke volume, cardiac output, pre-ejection period, total peripheral resistance), parasympathetic control (i.e., heart rate variability), and baroreflex function (i.e., baroreflex sensitivity) were obtained. The hypotensive group exhibited markedly lower stroke volume, heart rate, and cardiac output, as well as higher pre-ejection period and baroreflex sensitivity than the control group. Hypotension was furthermore associated with a smaller blood pressure response during stress. No group differences arose in total peripheral resistance and heart rate variability. While reduced beta-adrenergic myocardial drive seems to constitute the principal feature of the autonomic impairment that characterizes chronic hypotension, baroreflex-related mechanisms may also contribute to this state. Insufficient organ perfusion due to reduced cardiac output and deficient cardiovascular adjustment to situational requirements may be involved in the manifestation of bodily and mental symptoms.


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