Transfer function analysis of respiratory sinus arrhythmia: A measure of autonomic function in diabetic neuropathy

Freeman, Roy; Rj, Cohen; Jp, Saul

doi:10.1002/mus.880180111

Cited by 31 publications

(16 citation statements)

References 28 publications

(4 reference statements)

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“…Three, in D0 and D1 patients the autonomic impairment was more clear and consistent when quantified by multivariate analysis techniques than when separately focusing on blood pressure or RR interval variability alone. This is exemplified by previous data obtained through transfer function analysis between respiration and heart rate fluctuations, which has provided an accurate description of the features of autonomic cardiac control in these patients [36], and by the data obtained in our study by use of another multivariate approach, i. e. through time and frequency domain estimates of baroreflex. Thus, estimation of baroreflex cardiac modulation by joint analysis of blood pressure and RR interval fluctuations seems to be more sensitive in the early detection of autonomic cardiac neuropathy occurring in diabetes than the quantification of RR interval variability, the two measures showing only a limited correlation.…”

Section: Discussionsupporting

confidence: 64%

Time and frequency domain estimates of spontaneous baroreflex sensitivity provide early detection of autonomic dysfunction in diabetes mellitus

et al. 1997

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Diabetic autonomic dysfunction, even when not yet manifest, is associated with a high risk of mortality [1±11] which makes its early identification clinically important. In the early eighties Ewing and co-workers [1,12] validated a battery of laboratory tests for identification of autonomic abnormalities in patients with diabetes mellitus. These tests consist in the measurement of the heart rate changes induced by manouvers such as deep breathing, Valsalva and standing which engage reflexes that alter vagal and sympathetic modulation of the heart [13±17]. They further consist in the measurement of the blood pressure responses to standing, cold pressure test and hand-grip exercise which allow assessment of sympathetic modulation of systemic vascular resistance [15±19].Although useful for the identification of a diabetic-dependent damage of autonomic cardiovascular Diabetologia (1997) Summary Diabetic autonomic dysfunction is associated with a high risk of mortality which makes its early identification clinically important. The aim of our study was to compare the detection of autonomic dysfunction provided by classical laboratory autonomic function tests with that obtained through computer assessment of the spontaneous sensitivity of the baroreceptor-heart rate reflex (BRS) by time domain and frequency domain techniques. In 20 normotensive diabetic patients (mean age ± SD 41.9 ± 8.1 years) with no evidence of autonomic dysfunction on laboratory autonomic testing (D0) blood pressure (BP) and ECG were continuously monitored over 15 min in the supine position. BRS was assessed as the slope of the regression line between spontaneous increases or reductions in systolic BP and linearly related lengthening or shortening in RR interval over sequences of at least 4 consecutive beats (sequence method), or as the squared ratio between RR interval and systolic BP spectral powers around 0.1 Hz. We compared the results with those of 32 age-matched normotensive diabetic patients with abnormal autonomic function tests (D1) and with those of 24 healthy age-matched control subjects with normal autonomic function tests (C). Compared to C, BRS was markedly less in D1 when assessed by both the slope of the two types of sequences (data pooled) and by the spectral method (±71.3 % and ±60.2 % respectively, both p < 0.01). However, BRS was consistently although somewhat less markedly reduced in D0, the reduction being clearly evident for all the estimates (±57.0 % and ±43.5 %, both p < 0.01). The effects were more evident than those obtained by the simple quantification of the RR interval variability. These data suggest that time and frequency domain estimates of spontaneous BRS allow earlier detection of diabetic autonomic dysfunction than classical laboratory autonomic tests. The estimates can be obtained by short non-invasive recording of the BP and RR interval signals in the supine patient, i. e. under conditions suitable for routine outpatient evaluation. [Diabetologia (1997

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Section: Discussionsupporting

confidence: 64%

Time and frequency domain estimates of spontaneous baroreflex sensitivity provide early detection of autonomic dysfunction in diabetes mellitus

et al. 1997

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“…Moreover, CFT increases baroreflex sensitivity (BRS) -as determined by calculation of the LF transfer function gain between BP and HR [13,29,30]. The increase of BRS indicates that a given increase in blood pressure results in a greater decrease of heart rate during CFT than at rest [28]. Normally, it has been shown that BRS decreases during physical or psychological stress such as painful stimuli or physical effort [32].…”

Section: Discussionmentioning

confidence: 99%

“…To evaluate the influence of respiration on heart rate we calculated the gain of the transfer function between respiration and heart rate in the high frequency (0.15-0.5 Hz) band for coherence values above 0.5 [13,28]. To assess baroreceptor reflex sensitivity before and during cold face test, we calculated the gain of the transfer function between systolic blood pressure and heart rate in the low frequency (0.04-0.15 Hz) band for coherence values above 0.5 [13,20,29,30].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of cold face test bradycardia by means of spectral analysis

Stemper¹,

Hilz²,

Rauhut³

et al. 2002

Clinical Autonomic Research

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The cold face test (CFT) is a non-invasive challenge maneuver of the autonomic nervous system which activates the peripheral sympathetic and the cardiac parasympathetic nervous system and induces peripheral vasoconstriction and bradycardia. The physiology of CFT-induced bradycardia is still controversial. The heart rate decrease might result from a direct central up-regulation of cardiovagal activity or might be a secondary effect of baroreceptor activation or of changes of respiration. The purpose of this study was to analyze the origin of CFT-induced bradycardia. To evaluate the influence of respiration on bradycardia during CFT, we studied cardiac responses in 10 healthy volunteers during CFT (0-1 degrees C cold compresses for 60 s) with three different respiratory patterns: one with spontaneous and two with paced respiration (6 and 15 cycles/minute). We continuously monitored heart rate (HR), blood pressure (BP) and respiration and determined heart rate variability by assessment of coefficient of variation (CV), standard deviation (SD) and the root mean square of successive differences (RMSSD) of HR as well as low (LF) and high (HF) frequency spectra power of HR and BP. When coherence was above 0.5, we calculated the transfer function gain between HR and respiration in the HF band, as an index of respiratory sinus arrhythmia, and between HR and BP in the LF band, as an index of baroreflex sensitivity. HR decreased and BP increased significantly during the three types of CFT. The decrease of HR and the increase of BP, of time and frequency domain parameters did not differ between the three breathing patterns. Respiration, and HF and LF power of respiration did not change during CFT. The gain of the HF-transfer function between HR and respiration and the LF-transfer function gain between HR and BP increased significantly during CFT, but the increase did not differ between the three breathing patterns. The increase of the gain of both transfer functions is most likely due to an increase of vagal traffic and together with the unchanged respiratory pattern suggests that CFT-induced bradycardia is not due to baroreflex or respiratory influences, but seems to result from central vagal activation.

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“…In further analyses, we employed a measure of RSA adjusted for respiration by dividing untransformed RSA by Vt. Used in previous research (12,15,32,45,51,53), this parameter is the transfer function, or gain, of RSA in milliseconds per milliliter of tidal volume change. As with the uncorrected RSA analyses, we calculated individual-subject regressions of this RSA transfer function (RSATF) in relation to minute-to-minute HR, Vm, and accelerometer activity.…”

Section: Subjectsmentioning

confidence: 99%

Respiratory sinus arrhythmia, cardiac vagal control, and daily activity

Grossman¹,

Wilhelm²,

Spoerle³

2004

American Journal of Physiology-Heart and Circulatory Physiology

148

125

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Grossman, P, F. H. Wilhelm, and M. Spoerle. Respiratory sinus arrhythmia, cardiac vagal control, and daily activity. Am J Physiol Heart Circ Physiol 287: H728 -H734, 2004. First published January 29, 2004 10.1152/ajpheart.00825.2003.-Ambulatory respiratory sinus arrhythmia (RSA) or high-frequency heart rate (HR) variability is frequently employed as an index of cardiac parasympathetic control and related to risk or severity of cardiovascular disease. However, laboratory studies indicate variations in physical activity and respiratory parameters of rate and tidal volume may confound estimation of vagal activity. Because little is known about these relations outside the laboratory, we examined ambulatory relations among RSA, respiration, physical activity, and HR during waking hours by employing a multichannel monitoring system. Forty healthy young-to-middle aged adults underwent daytime monitoring that included continuous registration of the ECG, respiration (inductance plethysmography), and accelerometry motion activity. Within-individual regression analyses were performed to examine minute-to-minute relations between RSA and respiration, HR, and indexes of physical activity (minute ventilation and motion). HR changes were assumed to be strongly related to within-individual variations of vagal tone. RSA adjusted for respiratory parameters and unadjusted RSA were compared for strength of prediction of other measures. Unadjusted RSA was related to respiratory parameters (R ϭ 0.80) and moderately predicted minute-tominute HR and activity variances (means ϭ 56%, HR; 48%, minute ventilation; and 37%, motion). Adjusted RSA predicted significantly more HR and activity variance (means ϭ 75%, 76%, and 57%, respectively) with narrower confidence intervals. We conclude that ambulatory RSA magnitude is associated with respiratory variations and physical activity. Adjustment for respiratory parameters substantially improves relations between RSA and significantly vagally mediated HR and physical activity. Concurrent monitoring of respiration and physical activity may enhance HR variability accuracy to predict autonomic control.high-frequency heart rate variability; respiration; autonomic control; ambulatory monitoring; metabolic activity RESPIRATORY SINUS ARRHYTHMIA (RSA), or high-frequency heart rate (HR) variability (HRV), is frequently employed as a measure of cardiac vagal tone under ambulatory conditions. Among both patients and healthy persons, ambulatory RSA measures are increasingly used to elucidate patterns of autonomic modulation of cardiovascular control and to index disease risk or severity (7,10,25,33).A number of human and animal studies confirm that HR changes during mild-to-moderate increase and decrease in physical activity are under parasympathetic control to a significant degree (5, 9, 11, 15, 23, 26, 34, 36, 40 -42, 52). Therefore, fluctuations in daily physical activity, which are typically moderate in magnitude (e.g., walking at slow to moderate pace), should importantly reflect variations in cardiac ...

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Transfer function analysis of respiratory sinus arrhythmia: A measure of autonomic function in diabetic neuropathy

Cited by 31 publications

References 28 publications

Time and frequency domain estimates of spontaneous baroreflex sensitivity provide early detection of autonomic dysfunction in diabetes mellitus

Time and frequency domain estimates of spontaneous baroreflex sensitivity provide early detection of autonomic dysfunction in diabetes mellitus

Evaluation of cold face test bradycardia by means of spectral analysis

Respiratory sinus arrhythmia, cardiac vagal control, and daily activity

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