scholarly journals Cardiovagal Baroreflex Hysteresis Using Ellipses in Response to Postural Changes

2021 ◽  
Vol 15 ◽  
Author(s):  
Babak Dabiri ◽  
Joana Brito ◽  
Eugenijus Kaniusas

The cardiovagal branch of the baroreflex is of high clinical relevance when detecting disturbances of the autonomic nervous system. The hysteresis of the baroreflex is assessed using provoked and spontaneous changes in blood pressure. We propose a novel ellipse analysis to characterize hysteresis of the spontaneous respiration-related cardiovagal baroreflex for orthostatic test. Up and down sequences of pressure changes as well as the working point of baroreflex are considered. The EuroBaVar data set for supine and standing was employed to extract heartbeat intervals and blood pressure values. The latter values formed polygons into which a bivariate normal distribution was fitted with its properties determining proposed ellipses of baroreflex. More than 80% of ellipses are formed out of nonoverlapping and delayed up and down sequences highlighting baroreflex hysteresis. In the supine position, the ellipses are more elongated (by about 46%) and steeper (by about 4.3° as median) than standing, indicating larger heart interval variability (70.7 versus 47.9 ms) and smaller blood pressure variability (5.8 versus 8.9 mmHg) in supine. The ellipses show a higher baroreflex sensitivity for supine (15.7 ms/mmHg as median) than standing (7 ms/mmHg). The center of the ellipse moves from supine to standing, which describes the overall sigmoid shape of the baroreflex with the moving working point. In contrast to regression analysis, the proposed method considers gain and set-point changes during respiration, offers instructive insights into the resulting hysteresis of the spontaneous cardiovagal baroreflex with respiration as stimuli, and provides a new tool for its future analysis.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S682-S682
Author(s):  
Melissa J Benton ◽  
Amy L Silva-Smith ◽  
Jefferson M Spicher

Abstract Older adults with sarcopenia may be at risk for unstable postural blood pressure due to diminished lean mass that plays a role in maintaining fluid volume. Males have greater lean mass, so risk may be mediated by gender. We compared postural blood pressure changes in older men (77.1 ± 2.0 years; n = 15) and women (79.6 ± 2.0 years; n = 13) with sarcopenia before and after an overnight fast. Sarcopenia was defined using the Lean Mass Index (males ≤ 19.0 kg/m2; females ≤ 15.0 kg/m2). Body composition was measured using multi-frequency bioelectrical impedance, and blood pressure was measured lying, sitting, and standing. On Day 1 (normally hydrated) there were significant drops in systolic blood pressure, with an overall decrease of -9.1 ± 2.2 mmHg (p < 0.001) between lying and standing. On Day 2 (overnight fast), postural changes were more profound, with an overall decrease of -14.1 ± 2.8 mmHg (p < 0.001). However, when compared by gender, postural changes between lying and standing remained significant but did not differ between men and women (Day 1: men -8.9 ± 2.5 vs. women -9.3 ± 2.5 mmHg; Day 2: men -14.6 ± 4.6 vs. women -13.6 ± 3.1 mmHg). On both days diastolic blood pressure remained stable. In this group of older adults, significant decreases in postural systolic blood pressure were observed in the early morning fasted condition, increasing the risk for orthostatic hypotension (drop in systolic blood pressure -20.0 mmHg). Interestingly, gender did not influence risk.


2007 ◽  
Vol 25 (7) ◽  
pp. 1421-1426 ◽  
Author(s):  
Francesco US Mattace-Raso ◽  
Anton H van den Meiracker ◽  
Willem Jan Bos ◽  
Tischa JM van der Cammen ◽  
Berend E Westerhof ◽  
...  

1915 ◽  
Vol 21 (1) ◽  
pp. 43-83 ◽  
Author(s):  
John Auer

The monkey (Macacus rhesus) usually tolerates readily the repeated intraspinal injection of large doses of 0.3 per cent. tricresol antimeningitis serum. The spontaneous respiration is generally not disturbed. Doses of 0.3 per cent. tricresol serum as large as 8 c.c. per kilo were injected intraspinally with subsequent recovery, even when the monkey had a partial pneumothorax. Dangerous alterations of the respiration and blood pressure in the monkey after 0.3 per cent. tricresol serum given by syringe are apparently largely due to increased intraspinal pressure, for the mere reduction of this pressure has sufficed to bring about a prompt and complete recovery. The medullary centers of the monkey (vagus, respiratory, and vasomotor) are highly resistant to the action of sera when injected intraspinally, strikingly more so than those of the dog. Occasionally the mere introduction of a hypodermic needle into the spinal dural sac of non-anesthetized, unoperated monkeys which have already received injections of 0.3 per cent. tricresol serum, may produce a severe collapse. A preceding partial asphyxia seems to be a necessary condition. Large quantities of sera are rapidly absorbed from the spinal dural sac of monkeys, and the clotting time of the blood is decreased. The spinal meninges of the monkey are resistant to infection; even primitive precautions during intraspinal injections apparently suffice to prevent infection. Dogs are much more sensitive to the intraspinal injection of 0.3 per cent. tricresol serum than monkeys; nevertheless they may tolerate as much as 6 c.c. per kilo provided that intratracheal insufflation is maintained for some time after each injection. The chief danger in dogs after intraspinal injections of 0.3 per cent. tricresol is a cessation of the respiration; for this reason artificial respiration is necessary. The blood pressure in the dog may be profoundly lowered by 0.3 per cent. tricresol serum, yet recovery is usually obtained if intratracheal insufflation is maintained. The effects of 0.3 per cent. tricresol serum upon the medullary centers is interpreted to be the result of either excitatory or inhibitory stimuli. No evidence was found that either the respiratory, vasomotor, or vagus center is paralyzed. The local application of 0.3 per cent. tricresol serum upon the exposed medulla of dogs does not produce the same effect upon the respiration and blood pressure as intraspinal injection of the same serum. A solution of 0.3 per cent. tricresol serum applied locally to the medulla of dogs occasionally produces a transient respiratory stop page, without markedly affecting the blood pressure even when intratracheal insufflation is stopped. Increased intraspinal pressure was found to be an important factor in the production of respiratory and blood pressure changes in the dog after intraspinal injection of 0.3 per cent. tricresol serum. Both in the monkey and in the dog 0.3 per cent. chloroform serum, 0.3 per cent. ether serum, or plain horse serum produced in general a smaller effect upon the medullary centers than 0.3 per cent. tricresol serum. The ideal preservative for therapeutic sera would seem to be one which could be removed before injection. Ether in this respect is better than chloroform. The opsonins in antimeningitis serum are about equally affected by 0.3 per cent. tricresol, 0.3 per cent. chloroform, or 0.3 per cent. ether when tested after one week, one month, and three months. When intraspinal injections are given in the human being it would seem advisable to be prepared to withdraw part of the injected fluid and to administer artificial respiration, if necessary. For a safe withdrawal of fluid the gravity method is the best; for artificial respiration Meltzer's apparatus for pharyngeal insufflation is recommended.


2016 ◽  
Vol 61 (3) ◽  
pp. 369-379
Author(s):  
Robert Huhle ◽  
Joachim Siegert ◽  
Fred Wonka ◽  
Christoph Schindler ◽  
Marcelo Gama de Abreu ◽  
...  

Abstract Objective: To assess the eligibility for replacement of invasive blood pressure as measured “within” the arterial vessel (IBP) with non-invasive continuous arterial blood pressure (cNIP) monitoring during total intravenous anaesthesia (TIVA), the ability of cNiP to track fast blood pressure changes needs to be quantified. A new method of statistical data analysis is developed for this purpose. Methods: In a pilot study on patients undergoing neurosurgical anaesthesia, mean arterial pressure MAPIBP measured with IBP was compared to MAPCNP measured by the CNAP Monitor 500 in ten patients (age: 63±13 a). Correlation analysis of changes of device differences ΔeMAP=ΔMAPCNP-ΔMAPIBP with changes of MAPIBP (ΔMAPIBP) during intervals of vasoactivity was conducted. An innovative technique, of linear trend analysis (LTA) applied to two signals, is described to perform this analysis without a priori knowledge of intervals of vasoactivity. Results: Analysis of ΔeMAP during vasoactivity revealed that ΔMAPCNP systematically underestimated ΔMAPIBP by 37%. This was confirmed in the complete data set using LTA technique showing a systematic, yet patient specific, underestimation in tracking ΔMAPIBP (16…120%). Conclusion: The proposed LTA technique is able to detect systematic errors in tracking short-term blood pressure changes otherwise masked by established analysis. LTA may thus be a useful tool to assess the eligibility of cNIP to replace IBP during TIVA.


2000 ◽  
Vol 39 (02) ◽  
pp. 200-203
Author(s):  
H. Mizuta ◽  
K. Yana

Abstract:This paper proposes a method for decomposing heart rate fluctuations into background, respiratory and blood pressure oriented fluctuations. A signal cancellation scheme using the adaptive RLS algorithm has been introduced for canceling respiration and blood pressure oriented changes in the heart rate fluctuations. The computer simulation confirmed the validity of the proposed method. Then, heart rate fluctuations, instantaneous lung volume and blood pressure changes are simultaneously recorded from eight normal subjects aged 20-24 years. It was shown that after signal decomposition, the power spectrum of the heart rate showed a consistent monotonic 1/fa type pattern. The proposed method enables a clear interpretation of heart rate spectrum removing uncertain large individual variations due to the respiration and blood pressure change.


Sign in / Sign up

Export Citation Format

Share Document