Assessing spontaneous baroreflex in aged with pulse-pulse intervals and pulse amplitudes

Cardiac autonomic dysfunction is a serious condition in the elder subjects. Baroreflex sensitivity (BRS) by measuring pulse intervals and blood pressure has been proven as an effective indicator. This paper proposes a novel index by substitution blood pressure with amplitudes of pressure pulse. We recruited 61 subjects divided into two groups: healthy young subjects (Group1, n=33), healthy elders (Group2, n=28). The wrist pulse pressures of each subject were measured for 5 minutes to obtain pulse-pulse intervals and amplitudes then applied within the spontaneous sequence technique to calculate the pulse-pulse interval and amplitude ratio (PAR). We verified the reproducibility of PAR and agreement with spectral analysis of heart rate variability in group1 participants. We discovered significant differences between different groups in PAR (Group1 vs. Group2: 0.90±0.42 vs. 0.62±0.27, P=0.010). In contrast with measurements of BRS, this study proposes a simple approach without the necessity of blood pressure calibration or professional expertise to conduct measurements, thereby providing a convenient method for assessing autonomic function at home.

[1]  J. Bigger,et al.  Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction , 1998, The Lancet.

[2]  D. Adam,et al.  Assessment of autonomic function in humans by heart rate spectral analysis. , 1985, The American journal of physiology.

[3]  V. Larrue,et al.  Baroreflex Sensitivity Is Impaired in Bilateral Carotid Atherosclerosis , 2005, Stroke.

[4]  Sotirios Georgopoulos,et al.  The role of carotid plaque echogenicity in baroreflex sensitivity. , 2011, Journal of vascular surgery.

[5]  Andreas Voss,et al.  The interaction between pupil function and cardiovascular regulation in patients with acute schizophrenia , 2008, Clinical Neurophysiology.

[6]  R. Hughson,et al.  Spontaneous cardiac baroreflex in humans. Comparison with drug-induced responses. , 1995, Hypertension.

[7]  G. Pickering,et al.  Reflex Regulation of Arterial Pressure during Sleep in Man: A Quantitative Method of Assessing Baroreflex Sensitivity , 1969, Circulation research.

[8]  A. Pedotti,et al.  Evaluation of the Baroreceptor‐Heart Rate Reflex by 24‐Hour Intra‐arterial Blood Pressure Monitoring in Humans , 1988, Hypertension.

[9]  Massimo Pagani,et al.  Is reduced baroreflex gain a component of the metabolic syndrome? Insights from the LINOSA study , 2006, Journal of hypertension.

[10]  Hsien-Tsai Wu,et al.  Assessment of Endothelial Function Using Arterial Pressure Signals , 2011, J. Signal Process. Syst..

[11]  P. Chowienczyk,et al.  Noninvasive Assessment of the Digital Volume Pulse: Comparison With the Peripheral Pressure Pulse , 2000, Hypertension.

[12]  D. Kerr,et al.  Anthropometric measurement error and the assessment of nutritional status , 1999, British Journal of Nutrition.

[13]  A Pedotti,et al.  A new approach to analysis of the arterial baroreflex. , 1985, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[14]  L. Bernardi,et al.  Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking , 2008, European Respiratory Journal.

[15]  D. Shannon,et al.  Aging of modulation of heart rate. , 1987, The American journal of physiology.

[16]  R Peto,et al.  Effect of Age and High Blood Pressure on Barorefiex Sensitivity in Man , 1971, Circulation research.

[17]  M. O'Rourke,et al.  Prospective Evaluation of a Method for Estimating Ascending Aortic Pressure From the Radial Artery Pressure Waveform , 2001, Hypertension.

[18]  G Mancia,et al.  Early alterations of the baroreceptor control of heart rate in patients with acute myocardial infarction. , 1990, Circulation.

[19]  Falko Skrabal,et al.  Autonomic dysfunction and hemodynamics in vitamin B12 deficiency , 2002, Autonomic Neuroscience.

[20]  Giuseppe Mancia,et al.  Arterial Baroreflexes in Humans , 2011 .

[21]  Hsien-Tsai Wu,et al.  Arterial Stiffness Using Radial Arterial Waveforms Measured at the Wrist as an Indicator of Diabetic Control in the Elderly , 2011, IEEE Transactions on Biomedical Engineering.