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Am J Physiol Heart Circ Physiol 280: H1830-H1839, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 4, H1830-H1839, April 2001

Causal linear parametric model for baroreflex gain assessment in patients with recent myocardial infarction

Giandomenico Nollo1, Alberto Porta2, Luca Faes1, Maurizio Del Greco3, Marcello Disertori3, and Flavia Ravelli1

1 Dipartimento di Fisica, Università di Trento, and Istituto Trentino di Cultura-irst, 38050 Povo-Trento; 2 Dipartimento di Scienze Precliniche, Laboratorio Interdisciplinare Tecnologie Avanzale di Vialba, Università di Milano, 20157 Milano; and 3 Unità Operativa di Cardiologia, Ospedale Santa Chiara, 38100 Trento, Italy

Spectral and cross-spectral analysis of R-R interval and systolic arterial pressure (SAP) spontaneous fluctuations have been proposed for noninvasive evaluation of baroreflex sensitivity (BRS). However, results are not in good agreement with clinical measurements. In this study, a bivariate parametric autoregressive model with exogenous input (ARXAR model), able to divide the R-R variability into SAP-related and -unrelated parts, was used to quantify the gain (alpha ARXAR) of the baroreflex regulatory mechanism. For performance assessing, two traditional noninvasive methods based on frequency domain analysis [spectral, baroreflex gain by autogressive model (alpha AR); cross-spectral, baroreflex gain by bivariate autoregressive model (alpha 2AR)] and one based on the time domain [baroreflex gain by sequence analysis (alpha SEQ)] were considered and compared with the baroreflex gain by phenylephrine test (alpha PHE). The BRS evaluation was performed on 30 patients (61 ± 10 yr) with recent (10 ± 3 days) myocardial infarction. The ARXAR model allowed dividing the R-R variability (950 ± 1,099 ms2) into SAP-related (256 ± 418 ms2) and SAP-unrelated (694 ± 728 ms2) parts. alpha AR (12.2 ± 6.1 ms/mmHg) and alpha 2AR (8.9 ± 5.6 ms/mmHg) as well as alpha SEQ (12.6 ± 7.1 ms/mmHg) overestimated BRS assessed by alpha PHE (6.4 ± 4.7 ms/mmHg), whereas the ARXAR index gave a comparable value (alpha ARXAR = 5.4 ± 3.3 ms/mmHg). All noninvasive methods were significantly correlated to alpha PHE (alpha ARXAR and alpha SEQ were more correlated than the other indexes). Thus the baroreflex gain obtained describing the causal dependence of R-R interval on SAP showed a good agreement with alpha PHE and may provide additional information regarding the gain estimation in the frequency domain.

baroreflex sensitivity; spectral analysis; phenylephrine; autoregressive models; R-R-SAP transfer function


This article has been cited by other articles:


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 Am. J. Physiol. Heart Circ. Physiol.Home page
G. Nollo, L. Faes, A. Porta, R. Antolini, and F. Ravelli
Exploring directionality in spontaneous heart period and systolic pressure variability interactions in humans: implications in the evaluation of baroreflex gain
Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1777 - H1785.
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R. D. Lipman, J. K. Salisbury, and J. A. Taylor
Spontaneous Indices Are Inconsistent With Arterial Baroreflex Gain
Hypertension, October 1, 2003; 42(4): 481 - 487.
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 Am. J. Physiol. Heart Circ. Physiol.Home page
G. Nollo, L. Faes, A. Porta, B. Pellegrini, F. Ravelli, M. Del Greco, M. Disertori, and R. Antolini
Evidence of unbalanced regulatory mechanism of heart rate and systolic pressure after acute myocardial infarction
Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1200 - H1207.
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