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Variability in Cardiovascular Control: The Baroreflex Reconsidered

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Cardiovascular Engineering

Abstract

Although blood pressure control is often viewed as a paradigmatic example of a “homeostatic” biological control system, blood pressure levels can fluctuate considerably over shorter and longer time scales. In modern signal analysis, coherence between heart rate and blood pressure variability is used to estimate baroreflex gain. However, the shorter the measurement period, the more variability this gain factor reveals. We review evidence that this variability is not due to the technique used for the estimation, but may be an intrinsic property of the circulatory control mechanisms. The baroreflex is reviewed from its evolutionary origin, starting in fishes as a reflex mechanism to protect the gills from excessively high pressures by slowing the heart via the (parasympathetic) vagus nerve. Baroreflex inhibition of cardiovascular sympathetic nervous outflow is a later development; the maximally possible extent of sympathetic activity probably being set in the central nervous system by mechanisms other than blood pressure per se. In the sympathetic outflow tract not only baroreflex inhibition but also as yet unidentified, stochastic mechanisms decide to pass or not pass on the sympathetic activity to the periphery. In this short essay, the “noisiness” of the baroreflex as nervous control system is stressed. This property is observed in all elements of the reflex, even at the––supposedly––most basic relation between afferent receptor nerve input and efferent––vagus––nerve output signal.

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References

  • Aronson D, Mittleman MA, Burger AJ. Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. Am J Cardiol 2004;93:59–63.

    Article  PubMed  Google Scholar 

  • Benarroch EE. overview of the organization of the central autonomic network. In: Benarroch EE, editor. Central autonomic network: functional organization and clinical correlations. Armonk, NY: Futura Publishing Company, Inc.; 1997, 3–28.

    Google Scholar 

  • Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 1992;85:164–71.

    PubMed  Google Scholar 

  • Czermak JN. Über mechanische Vagusreizung beim Menschen. Jenaische Zeitschrift für Medicin und Naturwissenschaft 1865–1866;2:384–6.

  • de Cyon E, Ludwig C. Die Reflexe eines der sensiblen Nerven des Herzens auf die motorischen der Blutgefässe. Ber Verh Kön Sächs Ges Wiss Lpz (Math.-phys Cl) 1866;18:307–28.

    Google Scholar 

  • DeBoer RW, Karemaker JM, Strackee J. Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model. Am J Physiol 1987;253:H680-9.

    PubMed  CAS  Google Scholar 

  • Gallagher KM, Fadel PJ, Smith SA, Stromstad M, Ide K, Secher NH, Raven PB. The interaction of central command and the exercise pressor reflex in mediating baroreflex resetting during exercise in humans. Exp Physiol 2006;91:79–87.

    Article  PubMed  Google Scholar 

  • Guyenet PG. The sympathetic control of blood pressure. Nat Rev Neurosci 2006;7:335–46.

    Article  PubMed  CAS  Google Scholar 

  • Hering HE. Die Karotissinusreflexe auf Herz und Gefässe vom normal-physiologischen, pathologisch-physiologischen und klinischen Standpunkt. Dresden: Theodor Steinkopff Verlag; 1927.

    Google Scholar 

  • Heymans CJF, Folkow B. Vasomotor control and the regulation of blood pressure. In: Fishman AP, Richards DW, editors. Circulation of the blood. Men and ideas. Bethesda, Maryland: American Physiological Society; 1982, 407–86.

    Google Scholar 

  • Iriuchijima J. Cardiovascular physiology; nerve, flow and pressure. Tokyo: Igaku Shoin; 1972.

    Google Scholar 

  • Kienbaum P, Karlssonn T, Sverrisdottir YB, Elam M, Wallin BG. Two sites for modulation of human sympathetic activity by arterial baroreceptors? J Physiol 2001;531:861–9.

    Article  PubMed  CAS  Google Scholar 

  • Koch Eb. Die reflektorische Selbststeuerung des Kreislaufes. Dresden: Theodor Steinkopff Verlag; 1931.

    Google Scholar 

  • Köster GT. A Ueber den Nervus depressor als Reflexnerv der Aorta. Pflügers Archiv ges. Physiologie 1903;93:24–38.

    Article  Google Scholar 

  • Morris JL, Nilsson S. The circulatory system. In: Nilsson S, Holmgren S, editors. Comparative physiology and evolution of the autonomic nervous system. Chur, Switzerland: Harwood academic publishers. 1994, 193–246.

    Google Scholar 

  • Muratori, G. Histological observations on the structure of the carotid sinus in man and mammals. In: Kezdi P, editor. Baroreceptors and hypertension. Proceedings of an international symposium held at Dayton, Ohio, 16–17 November 1965. Oxford: Pergamon press; 1967. pp. 253–65.

  • Penaz, J. Photoelectric measurement of blood pressure, volume and flow in the finger. 10th international conference on medical and biological engineering––1973––Dresden. p.104.

  • Robbe HW, Mulder LJ, Ruddel H, Langewitz WA, Veldman JB, Mulder G. Assessment of baroreceptor reflex sensitivity by means of spectral analysis. Hypertension 1987;10:538–43.

    PubMed  CAS  Google Scholar 

  • 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;24:109–21.

    PubMed  CAS  Google Scholar 

  • Stein RB, Gossen ER, Jones KE. Neuronal variability: noise or part of the signal? Nat Rev Neurosci 2005;6:389–97.

    Article  PubMed  CAS  Google Scholar 

  • Sundin L, Nilsson S. Branchial innervation. J Exp Zool 2002;293:232–48.

    Article  PubMed  Google Scholar 

  • Tateishi Y, Oda S, Nakamura M, Watanabe K, Kuwaki T, Moriguchi T, Hirasawa H. Depressed heart rate variability is associated with high Il-6 blood level and decline in the blood pressure in septic patients. Shock 2007 Jun 28; [Epub ahead of print].

  • Taylor EW, Jordan D, Coote JH. Central control of the cardiovascular and respiratory systems and their interactions in vertebrates. Physiol Rev 1999;79:855–916.

    PubMed  CAS  Google Scholar 

  • Taylor JA, Eckberg DL. Fundamental relations between short-term RR interval and arterial pressure oscillations in humans. Circulation 1996;93:1527–32.

    PubMed  CAS  Google Scholar 

  • Topolski R, Inhoff AW. Loss of vision during the retinal stabilization of letters. Psychol Res 1995;58:155–62.

    Article  PubMed  CAS  Google Scholar 

  • Van Lieshout JJ. Cardiovascular reflexes in orthostatic disorders, Thesis, University of Amsterdam, 1989.

  • Wallin BG, Fagius J. Peripheral sympathetic neural activity in conscious humans. [Review]. Annu Rev Physiol 1988;50:565–76.

    Article  PubMed  CAS  Google Scholar 

  • Wesseling KH, Settels JJ. Baromodulation explains short-term blood pressure variability. In: Orlebeke JF, Mulder G, van Doornen LJP, editors. Psychophysiology of cardiovascular control. New York: Plenum Press. 1985, 69–97.

    Google Scholar 

  • Wesseling KH, Settels JJ, van der Hoeven GM, Nijboer JA, Butijn MW, Dorlas JC. Effects of peripheral vasoconstriction on the measurement of blood pressure in a finger. Cardiovasc Res 1985;19:139–45.

    PubMed  CAS  Google Scholar 

  • Westerhof BE, Gisolf J, Karemaker JM, Wesseling KH, Secher NH, Van Lieshout JJ. Time course analysis of baroreflex sensitivity during postural stress. Am J Physiol Heart Circ Physiol 2006;291:H2864–74.

    Article  PubMed  CAS  Google Scholar 

  • Westerhof BE, Gisolf J, Stok WJ, Wesseling KH, Karemaker JM. Time-domain cross-correlation baroreflex sensitivity: performance on the EUROBAVAR data set. J Hypertens 2004;22:1371–80.

    Article  PubMed  CAS  Google Scholar 

  • Winchell RJ, Hoyt DB. Analysis of heart-rate variability: a noninvasive predictor of death and poor outcome in patients with severe head injury. J Trauma 1997;43:927–33.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to John M. Karemaker.

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Karemaker, J.M., Wesseling, K.H. Variability in Cardiovascular Control: The Baroreflex Reconsidered. Cardiovasc Eng 8, 23–29 (2008). https://doi.org/10.1007/s10558-007-9046-4

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