Noninvasive Provocations of Baroreflex Sensitivity

Kautzner, Josef

doi:10.1002/9780470987483.ch17

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…Concomitantly, we measured central arterial compliance, which provides information on the elastic properties of the central arteries where arterial baroreceptors are embedded, to obtain insight into the relation between the distensibility of central arteries and baroreflex function. In accordance with previous observations (19, 37, 38, 39), we found an inverse correlation between BRS and age, heart rate, and blood pressure. Additionally, our findings are consistent with previous data showing a negative relationship between BRS and both fasting plasma glucose and HOMA‐IR index (40, 41, 42), as well as between BRS and triglyceride levels (43).…”

Section: Discussionsupporting

confidence: 93%

“…The direct effects of these pharmacological agents on the heart and the necessity of intravenous cannulation limit the applicability of this method (16). Spontaneous BRS estimation provides BRS assessment through the quantification of the change in cardiac cycle length per unit of spontaneous change in systolic blood pressure (18, 19). Most studies estimate spontaneous BRS by using continuous peripheral blood pressure measurements (20, 21, 22).…”

Section: Introductionmentioning

confidence: 99%

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Baroreflex Sensitivity in Obesity: Relationship With Cardiac Autonomic Nervous System Activity

Skrapari

Tentolouris

Περρέα

et al. 2007

Obesity

127

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[1685][1686][1687][1688][1689][1690][1691][1692][1693]. Objective: The aim of this study was to test the hypothesis that baroreflex sensitivity (BRS), assessed by indirect measurement of aortic pressure, is blunted in obesity. Additionally, the potential effect of cardiac autonomic nervous system (ANS) activity, aortic compliance, and metabolic parameters on BRS of obese subjects was investigated. Research Methods and Procedures:A group of 30 women with BMI Ͼ30 kg/m 2 and a group of 30 controls with BMI Ͻ25 kg/m 2 were examined. BRS was estimated by the sequence technique, cardiac ANS activity by short-term spectral analysis of heart rate variability (HRV), and aortic compliance by the method of applanation tonometry. Results: BRS was lower in obese women (9.18 Ϯ 3.77 vs. 19.63 Ϯ 9.16 ms/mm Hg, p Ͻ 0.001). The median values (interquartile range) of the power of both the high-frequency and low-frequency components of the HRV were higher in the lean than in the obese participants Multivariate analysis demonstrated a significant and independent association between BRS and age (p ϭ 0.003), BMI (p Ͻ 0.001), and high-frequency power of HRV (p Ͻ 0.001). These variables explained 72% of the variation of BRS values. Discussion: BRS is severely reduced in obese subjects. BMI, age, and the parasympathetic nervous system activity are the main determinants of BRS. Baroreflex behavior is of clinical relevance because an attenuated BRS represents a negative prognostic factor in cardiovascular diseases, which are common in obesity.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Baroreflex Sensitivity in Obesity: Relationship With Cardiac Autonomic Nervous System Activity

Skrapari

Tentolouris

Περρέα

et al. 2007

Obesity

127

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“…More recently, spontaneous methods have been described, which are based on the interbeat interval changes reflexly induced by BP changes that spontaneously occur in daily life [14]. The available techniques for the assessment of the interaction between heart rate and arterial BP are principally the sequence method, which evaluates BRS in a time domain and the spectral method, which evaluates BRS in a frequency domain technique [15]. In addition, of special interest are methods of mathematical modeling, which have been constructed in order to describe baroreflex behavior, acknowledging the closed loop interaction between BP and heart rate as well as external or internal influences on BP and heart rate.…”

Section: Methods For Brs Estimationmentioning

confidence: 99%

Baroreflex Function: Determinants in Healthy Subjects and Disturbances in Diabetes, Obesity and Metabolic Syndrome

Skrapari¹,

Tentolouris²,

Katsilambros³

2006

CDR

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Arterial baroreceptors play an important role in the short-term regulation of arterial pressure, by reflex chronotropic effect on the heart and by reflex regulation of sympathetic outflow. Baroreflex sensitivity (BRS) represents an index of arterial baroreceptors function. Several methods of measuring BRS are available nowadays. Different factors influence BRS in the healthy population, including sex, age, blood pressure, heart rate, body fatness, arterial stiffness, blood glucose and insulin levels, as well as physical activity. Baroreceptors dysfunction is evident in diseases such as coronary artery disease, heart failure, arterial hypertension, diabetes mellitus and obesity. The underlying mechanism of BRS attenuation in diabetes or obesity is not yet well known; however, there is increasing evidence that it is at least partly related to autonomic nervous system dysfunction and particularly to sympathetic overactivity that accompanies these diseases. Blunted BRS provides prognostic information for cardiovascular diseases and possibly for diabetes, while its' prognostic information for obesity is not yet established. This review deals with the mechanisms affecting baroreflex function, the newer techniques of BRS estimation and the most recent insights of baroreflex function in the healthy population and in various diseases with emphasis on diabetes and obesity. In addition, the clinical implication of a reduced BRS in these disorders is discussed.

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“…Η πτώση της αρτηριακής πίεσης και των καρδιακών σφύξεων είναι πιθανότατα αποτέλεσµα της ενεργοποίησης του τασεοαντανακλαστικού, η οποία εκδηλώνεται µε αύξηση της παρασυµπαθητικής δραστηριότητας, λόγω διάτασης των καρωτιδικών υποδοχέων, κατά την τοποθέτηση του ενδοαυλικού νάρθηκα και την διαστολή της βλάβης201 . µετρά την τασεο-ευαισθησία µέσω υπολογισµού της αλλαγής του µήκους του καρδιακού κύκλου, ανά µονάδα αυτόµατης αλλαγής της συστολικής αρτηριακής πίεσης204,205 . Είναι µη επεµβατική, εύκολη και πρακτική µέθοδος.…”

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Μεταβολές Στην Ευαισθησία Των Τασεοϋποδοχέων Του ΑΝΣ Σε Ασθενείς Μετά Από Ενδαρτηρεκτομή Των Καρωτίδων Και Συσχέτιση Των Ευρημάτων Με Την Υπερηχογραφική Εικόνα Και Τα Χαρακτηριστικά Της Αθηρωσκληρωτικής Πλάκας

Tsekouras¹,

Τσεκούρας²

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Background: The net effect of unilateral carotid endarterectomy (CEA), on baroreflex sensitivity, depends on the counteraction of various suggested mechanisms. Aim: To investigate if the morphology of carotid plaque is another factor that can affect baroreflex function. Methods: Forty-two patients (27 male; mean age 69.09 years) were evaluated. Patients were classified into 2 groups, preoperatively, according to the echogenicity of the plaque, (Gray-Waele classification). Plaques of grades 1 and 2 were defined as echolucent plaques and those of grades 3 and 4 were defined as echogenic. All patients were subjected to elective CEA, using ultraluminal carotid shunt and vein patch. Spontaneous baroreflex sensitivity (sBRS), as a reliable index of responsiveness of the baroreflex, was calculated with the sequence method. Preoperative patient characteristics were compared using the x2 test, Fisher’s exact test, or the independent samples t test. We evaluated hemodynamic parameters, without taking into account the echogenicity of the plaque, using Friedman and Wilcoxon tests. Hemodynamic parameters between the 2 groups of plaques were calculated with multiple and simple analysis of covariance. Results: Patients with echolucent plaques had diabetes mellitus and symptomatic plaques at a significantly greater incidence ( 2=8.077, p=0.004, #ι 2=8.576, p=0.003 respectively). There was an overall reducing of sBRS after CEA, ( 2=32.605, p<0,001). Before endarterectomy, sBRS was greater in patients with echolucent plaques, compared to patients with echogenic plaques (F=10.065, p=0.003). Postoperatively this difference was eliminated. Conclusions: Only preoperatively echogenicity can affect baroreflex function in patients with carotid artery disease. This finding has a special clinical impact in these patients.

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Noninvasive Provocations of Baroreflex Sensitivity

Cited by 6 publications

References 25 publications

Baroreflex Sensitivity in Obesity: Relationship With Cardiac Autonomic Nervous System Activity

Baroreflex Sensitivity in Obesity: Relationship With Cardiac Autonomic Nervous System Activity

Baroreflex Function: Determinants in Healthy Subjects and Disturbances in Diabetes, Obesity and Metabolic Syndrome

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