Low-frequency oscillations in R–R interval and blood pressure across the continuum of cardiovascular risk

The purpose of this study was to assess the power and the frequency of low-frequency (LF; 0.04-<0.15 Hz) oscillations in systolic blood pressure (SBP) and R-R interval (RRi) across the continuum of risk of cardiovascular disease, including age. A potential confound in such determinations is low spontaneous breathing frequency in some individuals. We measured beat-to-beat SBP, RRi and respiration in healthy YOUNG (33±3 years) and OLDER subjects (62±5 years) and older patients with hypertension (HT, 61±5 years), coronary artery disease without (CAD, 62±5 years) and with type 2 diabetes (CAD+DM, 62±4 years, n=28 for all groups) during spontaneous breathing at supine rest. Power (Power(LF)) and median frequency (Med(LF)) of LF oscillations were calculated by power spectral analysis after removing respiratory effects by least-mean-square adaptive filtering. OLDER had higher Power(LF-SBP) (5.5±3.0 vs. 3.4±2.5 mmHg(2), p=0.002) and lower Power(LF-RRi) than YOUNG (339±460 vs. 575±422 ms(2), p=0.001) whereas neither variable differed between OLDER and patient groups. Med(LF-SBP) (0.072±0.009 vs. 0.080±0.011 Hz, p=0.005) and Med(LF-RRi) (0.072±0.010 vs. 0.079±0.013 Hz, p=0.027) were lower in OLDER compared with YOUNG. Compared with OLDER, Med(LF-RRi) was lower in CAD (0.065±0.006 Hz, p=0.015) and CAD +DM (0.066±0.008 Hz, p=0.012); whereas CAD+DM had also lower Med(LF-SBP) (0.065±0.006 Hz, p=0.012). No differences were observed between OLDER and HT and between CAD and CAD+DM in these variables. We concluded that age is major determinant of the power of LF oscillations in SBP and RRi at rest, whereas the median frequency of these oscillations is altered also by coronary artery disease.

[1]  D. O'Leary,et al.  Role of cardiac output in mediating arterial blood pressure oscillations. , 1996, The American journal of physiology.

[2]  J Strackee,et al.  Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model. , 1987, The American journal of physiology.

[3]  Sophocles J. Orfanidis,et al.  Introduction to signal processing , 1995 .

[4]  T. Seppänen,et al.  Frequency of slow oscillations in arterial pressure and R–R intervals during muscle metaboreflex activation , 2010, Autonomic Neuroscience.

[5]  Douglas R Seals,et al.  Low-frequency arterial pressure fluctuations do not reflect sympathetic outflow: gender and age differences. , 1998, American journal of physiology. Heart and circulatory physiology.

[6]  Pamela S Douglas,et al.  Acc/aha/ase 2003 Guideline Update for the Clinical Application of Echocardiography: Summary Article a Report of the American College of Cardiology/american Heart Association Task Force on Practice Guidelines (acc/aha/ase Committee to Update the 1997 Guidelines for the Clinical Application of Echocar , 2003 .

[7]  Richard P. Lewis,et al.  ACC/AHA Guidelines for the Clinical Application of Echocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography). Developed in collaboration with the American Society of Echocardio , 1997, Circulation.

[8]  G. Preiss,et al.  Patterns of sympathetic neuron activity associated with Mayer waves. , 1974, The American journal of physiology.

[9]  D. Seals,et al.  Increased abdominal-to-peripheral fat distribution contributes to altered autonomic-circulatory control with human aging. , 2004, American journal of physiology. Heart and circulatory physiology.

[10]  Tapio Seppänen,et al.  Reducing the Effect of Respiration in Baroreflex Sensitivity Estimation With Adaptive Filtering , 2008, IEEE Transactions on Biomedical Engineering.

[11]  Juha Hartikainen,et al.  Sympathovagal balance is major determinant of short-term blood pressure variability in healthy subjects. , 1999, American journal of physiology. Heart and circulatory physiology.

[12]  M. Joyner,et al.  Aging and Forearm Postjunctional &agr;-Adrenergic Vasoconstriction in Healthy Men , 2002, Circulation.

[13]  Jens Jordan,et al.  Baroreflex Buffering Is Reduced With Age in Healthy Men , 2003, Circulation.

[14]  P. Novak,et al.  Influence of respiration on heart rate and blood pressure fluctuations. , 1993, Journal of applied physiology.

[15]  A Malliani,et al.  Central vagotonic effects of atropine modulate spectral oscillations of sympathetic nerve activity. , 1998, Circulation.

[16]  C. Julien,et al.  The arterial baroreceptor reflex of the rat exhibits positive feedback properties at the frequency of Mayer waves , 1998, The Journal of physiology.

[17]  H. Huikuri,et al.  Time domain, geometrical and frequency domain analysis of cardiac vagal outflow: effects of various respiratory patterns. , 2001, Clinical physiology.

[18]  D. Eckberg,et al.  Important influence of respiration on human R-R interval power spectra is largely ignored. , 1993, Journal of applied physiology.

[19]  A. Porta,et al.  Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus. , 2000, Circulation.

[20]  A. Porta,et al.  Contrasting effects of phentolamine and nitroprusside on neural and cardiovascular variability. , 2001, American journal of physiology. Heart and circulatory physiology.

[21]  M. Elam,et al.  Increased sympathetic nerve activity in renovascular hypertension. , 1999, Circulation.

[22]  Esko Vanninen,et al.  Short-term blood pressure variability in renovascular hypertension and in severe and mild essential hypertension. , 2003, Clinical science.

[23]  A. Malliani,et al.  Changes in Autonomic Regulation Induced by Physical Training in Mild Hypertension , 1988, Hypertension.

[24]  S. Haykin,et al.  Adaptive Filter Theory , 1986 .

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

[26]  R. Cohen,et al.  Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. , 1981, Science.

[27]  D L Eckberg,et al.  Fundamental relations between short-term RR interval and arterial pressure oscillations in humans. , 1996, Circulation.

[28]  T. Seppänen,et al.  Novel spectral indexes of heart rate variability as predictors of sudden and non‐sudden cardiac death after an acute myocardial infarction , 2007, Annals of medicine.

[29]  A. Porta,et al.  Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. , 1997, Circulation.

[30]  M. Turiel,et al.  Power Spectral Analysis of Heart Rate and Arterial Pressure Variabilities as a Marker of Sympatho‐Vagal Interaction in Man and Conscious Dog , 1986, Circulation research.

[31]  L. Graham,et al.  Time Course of Sympathetic Neural Hyperactivity After Uncomplicated Acute Myocardial Infarction , 2002, Circulation.

[32]  B. Chapuis,et al.  Dynamic interactions between arterial pressure and sympathetic nerve activity: role of arterial baroreceptors. , 2003, American journal of physiology. Regulatory, integrative and comparative physiology.

[33]  C. D. De Luca,et al.  Frequency Parameters of the Myoelectric Signal as a Measure of Muscle Conduction Velocity , 1981, IEEE Transactions on Biomedical Engineering.

[34]  Wouter Wieling,et al.  Effects of aging on blood pressure variability in resting conditions. , 1994 .

[35]  Richard P. Lewis,et al.  ACC/AHA guidelines for the clinical application of echocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee to Develop Guidelines for the Clinical Application of Echocard , 1990, Circulation.

[36]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[37]  P. Bjerregaard,et al.  Spectral components of short-term RR interval variability in healthy subjects and effects of risk factors. , 1994, European heart journal.

[38]  M Pagani,et al.  Absence of low-frequency variability of sympathetic nerve activity in severe heart failure. , 1997, Circulation.

[39]  Luca T. Mainardi,et al.  Extraction of the respiration influence from the heart rate variability signal by means of lattice adaptive filter , 1994, Proceedings of 16th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[40]  I. Korhonen,et al.  Circadian profile of low-frequency oscillations in blood pressure and heart rate in hypertension. , 1999, American journal of hypertension.

[41]  R. Cohen,et al.  Hemodynamic regulation: investigation by spectral analysis. , 1985, The American journal of physiology.

[42]  R. Kaminski,et al.  Sympathetic unit activity associated with Mayer waves in the spinal dog. , 1970, The American journal of physiology.

[43]  P. Lanting,et al.  Spectral Analysis of Spontaneous Heart Rate Variation in Diabetic Patients , 1990, Diabetic medicine : a journal of the British Diabetic Association.

[44]  A. Ng,et al.  Age and gender influence muscle sympathetic nerve activity at rest in healthy humans. , 1993, Hypertension.

[45]  A L Goldberger,et al.  Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. , 2000, Circulation.

[46]  R. Maestri,et al.  Short-Term Heart Rate Variability Strongly Predicts Sudden Cardiac Death in Chronic Heart Failure Patients , 2003, Circulation.