Abstract
The objective of this study was to compare the baroreflex sensitivity (BRS) assessed by the new, non-invasive, spontaneous sequence method (BRS-sequence) with the Valsalva manoeuvrebased BRS. Fourteen healthy volunteers were studied in the supine position, during 60° head-up tilt (HUT) and during −30° head-down tilt (HDT). Blood pressure and R-R intervals were continuously and non-invasively recorded using a Finapres device. The BRS-sequence was assessed by analysing the slopes of spontaneously occurring sequences of three or more consecutive beats in which systolic blood pressure and R-R interval of the following beat increased or decreased in the same direction in a linear fashion; it was compared with data obtained during the Valsalva manoeuvre in each position. The time and frequency domain indices of R-R interval variability were also evaluated. The mean difference of BRS between the two non-invasive methods was 3.86 ms/mmHg with a standard deviation of 9.14 ms/mmHg. BRS was decreased during HUT and increased during HDT as assessed by both techniques. The changes in BRS were associated with vagal withdrawal and sympathetic activation during HUT and enhancement in the cardiac vagal tone and reduction in the sympathetic activity during HDT. We conclude that the BRS-sequence technique provides a reliable method to study the neural control of the circulation, although the body position in consecutive measurements needs to be standardized.
Similar content being viewed by others
References
Bristow JD, Honour AJ, Pickering GW, Sleight P, Smith HS. Diminished baroreflex sensitivity in high blood pressure.Circulation 1969;39: 48–54.
Mancia G, Ferrari AU, Zanchetti A. Reflex control of the circulation in experimental and human hypertension. In: Zanchetti A, Tarazi RC, eds.Handbook of Hypertension. Volume 8. Pathophysiology of Hypertension: Regulatory Mechanisms. Amsterdam: Elsevier, 1986; 47–68.
La Rovere MT, Specchia G, Mortara A, Schwartz PJ. Baroreflex sensitivity, clinical correlates, and cardiovascular mortality among patients with a first myocardial infarction: a prospective study.Circulation 1988;78: 816–824.
Schwartz PJ, Zaza A, Pala M, Locati E, Beria G, Zanchetti A. Baroreflex sensitivity and its evolution during the first year after myocardial infarction.J Am Coll Cardiol 1988;12: 629–636.
Eckberg DL, Drabinsky M, Braunwald E. Defective cardiac parasympathetic control in patients with heart diseases.N Engl J Med 1971;285: 877–883.
Sopher SM, Smith ML, Eckberg DL, Fritsch JM, Dibner-Dunlap ME. Autonomic pathophysiology in heart failure: carotid baroreceptor-cardiac reflexes.Am J Physiol 1990;259: H689-H696.
Ellenbogen KA, Mohanty PK, Szentpetery S. Arterial baroreflex abnormalities in heart failure: reversal after orthotopic cardiac transplantation.Circulation 1989;79: 51–58.
Mancia G, Ludbrook J, Ferrari A, Gregorini L, Zanchetti A. Baroreceptor reflexes in human hypertension.Circ Res 1978;43: 170–177.
Farell TG, Paul V, Cripps TRet al. Baroreflex sensitivity and electrophysiological correlates in patients after acute myocardial infarction.Circulation 1991;83: 945–952.
Pickering TG, Sleight P. Quantitative index of baroreflex activity in normal and hypertensive subjects using Valsalva's maneuver.Br Heart J 1969;31: 392.
Airaksinen KEJ, Hartikainen JEK, Niemelä MJ, Huikuri HV, Mussalo HM, Tahvanainen KOU. Valsalva maneuver in the assessment of baroreflex sensitivity in patients with coronary artery disease.Eur Heart J 1993;14: 1519–1523.
Hughson RL, Quintin L, Annat G, Yamamoto Y, Gharib C. Spontaneous baroreflex by sequence and power spectral methods in humans.Clin Physiol 1993;13: 663–676.
Omboni S, Parati G, Frattola Aet al. Spectral and sequence analysis of finger blood pressure variability. Comparison with analysis of intra-arterial recordings.Hypertension 1993;22: 26–33.
Parati G, Casadei R, Groppelli M, Di Rienzo M, Mancia G. Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing.Hypertension 1989;13: 647–655.
Wesseling KH, deWit B, Settels JJ, Klawer WH. On the indirect registration of finger blood pressure after Penaz.Funct Biol Med 1982;1: 245–250.
Kardos A, Gingl Z. Continuous non invasive on-line monitoring system for blood pressure and heart rate variability in humans.Cardiol Hung 1994;2: 39–51.
Blaber AP, Yamamoto Y, Hughson RL. Methodology of spontaneous baroreflex relationship assessed by surrogate data analysis.Am J Physiol 1995;268: H1682-H1687.
Bloomfield P.Fourier Analysis of Time Series: An Introduction. New York: John Wiley, 1976.
Pagani M, Lombardi F, Guzzetti Set al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympathovagal interaction in man and conscious dog.Circ Res 1986;56: 178–193.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement.Lancet 1986;i:307–310.
Smyth HS, Sleight P, Pickering GW. Reflex regulation of arterial pressure during sleep in man: a quantitative method of assessing baroreflex sensitivity.Circ Res 1969;24: 109–121.
Goldstein DS, Horwitz D, Keiser HR. Comparison of techniques for measuring baroreflex sensitivity in man.Circulation 1982;66: 432–441.
Goldman WF, Saum WR. A direct excitatory action of catecholamines on rat aortic baroreceptors in vitro.Circ Res 1984;55: 18–30.
Tomomatsu E, Nishi K. Increased activity of carotid sinus baroreceptors by sympathetic stimulation and norepinephrine.Am J Physiol 1981;240: 650–658.
Pardini BJ, Lund DD, Schmid PG. Contrasting preganglionic and postganglionic effects of phenylephrine on parasympathetic control of heart rate.Am J Physiol 1991;260: H118-H122.
McGrattan PA, Brown JH, Brown OM. Parasympathetic effects on in vivo heart can be regulated through an alpha 1-adrenergic receptor.Circ Res 1987;60: 465–471.
Conway J, Boon N, Jones JV, Sleight P. Involvement of the baroreceptor reflexes in the changes in blood pressure with sleep and mental arousal.Hypertension 1983;5: 746–748.
Palmero HA, Caeiro TF, Iosa DJ, Bas J. Baroreceptor reflex sensitivity derived from phase 4 of the Valsalva maneuver.Hypertension 1981;3 (suppl. II): 134–137.
Trimarco B, Volpe M, Ricciardelli Bet al. Valsalva maneuver in the assessment of baroreflex responsiveness in borderline hypertensives.Cardiology 1983;70: 6–14.
Smith SA, Stallard TJ, Salih MM, Litter WA. Can sino-aortic baroreceptor heart rate reflex sensitivity be determined from phase 4 of the Valsalva maneuver?Cardiovasc Res 1987;21: 422–427.
Harrison MH. Athletes, astronauts and orthostatic tolerance.Sports Med 1986;3: 428–435.
Gingl Z, Rudas L, Kardos A. Effects of electrical artifacts and extrasystolic arrhythmia on the linear and spectral markers of the spontaneous baroreflex sensitivity.Cardiol Hung 1996; suppl. 2: 29.
Steptoe A, Vogele C. Cardiac function during postural changes assessed using non-invasive spontaneous sequence analysis in young man.Cardiovasc Res 1990;24: 627–632.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kardos, A., Rudas, L., Simon, J. et al. Effect of postural changes on arterial baroreflex sensitivity assessed by the spontaneous sequence method and Valsalva manoeuvre in healthy subjects. Clinical Autonomic Research 7, 143–148 (1997). https://doi.org/10.1007/BF02308842
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02308842