Estimation of spontaneous baroreflex sensitivity using transfer function analysis: effects of positive pressure ventilation
-
Martin Glos
, Dietrich Romberg , Susanne Endres and Ingo Fietze
Abstract
To determine the short-term effects of non-invasive positive pressure ventilation (PPV) on spontaneous baroreflex sensitivity, we acquired time series of RR interval and beat-to-beat blood pressure in 55 healthy volunteers (mean age 46.5±10.5 years), who performed breathing tests on four occasions at frequencies of 12 and 15/min, with application of PPV of 5 mbar, and without positive pressure (control). Using spectral and transfer function analysis, we estimated RR interval variability (HRV) and systolic blood pressure variability (SBPV), as well as the gain (α-index) and phase shift (Φ) of the baroreceptor reflex for low- (LF) and high-frequency (HF) bands. Compared to control breathing, PPV at 12 and 15/min led to an increase in mean RR (p<0.001) and blood pressure (p<0.05). The α-index in the HF band increased significantly due to PPV for both respiratory frequencies (p<0.05). Phase shifts did not show significant changes in response to pressure ventilation. These results indicate that short-term administration of PPV in normal subjects elicits significant enhancement in the HF index of baroreflex gain. These findings may contribute to understanding the mechanisms, indications, and effectiveness of positive pressure breathing strategies in treating cardiorespiratory and other disease conditions.
References
[1] van-de-Borne P, Mezzetti S, Montano N, Narkiewicz K, Degaute JP, Somers VK. Hyperventilation alters arterial baroreflex control of heart rate and muscle sympathetic nerve activity. Am J Physiol Heart Circ Physiol2000; 279: H536–H541.10.1152/ajpheart.2000.279.2.H536Search in Google Scholar PubMed
[2] Belozeroff V, Berry RB, Sassoon CS, Khoo MC. Effects of CPAP therapy on cardiovascular variability in obstructive sleep apnea: a closed-loop analysis. Am J Physiol Heart Circ Physiol2002; 282: H110–H121.10.1152/ajpheart.2002.282.1.H110Search in Google Scholar PubMed
[3] Bonsignore MR, Parati G, Insalaco G, et al. Continuous positive airway pressure treatment improves baroreflex control of heart rate during sleep in severe obstructive sleep apnea syndrome. Am J Respir Crit Care Med2002; 166: 279–286.10.1164/rccm.2107117Search in Google Scholar PubMed
[4] Narkiewicz K, Kato M, Phillips BG, Pesek CA, Davison DE, Somers VK. Nocturnal continuous positive airway pressure decreases daytime sympathetic traffic in obstructive sleep apnea. Circulation1999; 100: 2332–2335.10.1161/01.CIR.100.23.2332Search in Google Scholar PubMed
[5] Naughton MT, Benard DC, Liu PP, Rutherford R, Rankin F, Bradley TD. Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med1995; 152: 473–479.10.1164/ajrccm.152.2.7633695Search in Google Scholar PubMed
[6] Tkacova R, Dajani HR, Rankin F, Fitzgerald FS, Floras JS, Douglas BT. Continuous positive airway pressure improves nocturnal baroreflex sensitivity of patients with heart failure and obstructive sleep apnea. J Hypertens2000; 18: 1257–1262.10.1097/00004872-200018090-00012Search in Google Scholar PubMed
[7] Logan AG, Tkacova R, Perlikowski SM, et al. Refractory hypertension and sleep apnoea: effect of CPAP on blood pressure and baroreflex. Eur Respir J2003; 21: 241–247.10.1183/09031936.03.00035402Search in Google Scholar PubMed
[8] Penzel T, Peter JH. [Diagnosis of sleep disorders and medical sleep-related diseases – a review] (in German with English abstract). Biomed Tech2003; 48: 47–54.Search in Google Scholar
[9] Torok T, Rudas L, Kardos A, Paprika D. The effects of patterned breathing and continuous positive airway pressure on cardiovascular regulation in healthy volunteers. Acta Physiol Hung1997; 85: 1–10.Search in Google Scholar
[10] Laude D, Elghozi JL, Girard A, et al. Comparison of various techniques used to estimate spontaneous baroreflex sensitivity (the EuroBaVar study). Am J Physiol Regul Integr Comp Physiol2004; 286: R226–R231.10.1152/ajpregu.00709.2002Search in Google Scholar PubMed
[11] Parati G, Di Rienzo M, Mancia G. How to measure baroreflex sensitivity: from the cardiovascular laboratory to daily life. J Hypertens2000; 18: 7–19.10.1097/00004872-200018010-00003Search in Google Scholar
[12] Parati G, Casadei R, Groppelli A, Di RM, Mancia G. Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing. Hypertension1989; 13: 647–655.10.1161/01.HYP.13.6.647Search in Google Scholar
[13] Gizdulich P, Imholz BP, van den Meiracker AH, Parati G, Wesseling KH. Finapres tracking of systolic pressure and baroreflex sensitivity improved by waveform filtering. J Hypertens1996; 14: 243–250.10.1097/00004872-199602000-00014Search in Google Scholar
[14] Glos M, Romberg D, Fietze I, Röttig J, Knobe M, Witt C. Analysis of heart rate and blood pressure variability during nasal continuous positive airway pressure therapy in patients with obstructive sleep apnea. Comput Cardiol1999; 26: 603–606.Search in Google Scholar
[15] Suhrbier A, Heringer R, Walther T, Malberg H, Wessel N. Comparison of three methods for beat-to-beat-interval extraction from continuous blood pressure and electrocardiogram with respect to heart rate variability analysis. Biomed Tech2006; 51: 70–76.10.1515/BMT.2006.013Search in Google Scholar
[16] Lippman N, Stein KM, Lerman BB. Comparison of methods for removal of ectopy in measurement of heart rate variability. Am J Physiol1994; 267: H411–H418.10.1152/ajpheart.1994.267.1.H411Search in Google Scholar
[17] Welch PD. The use of fast Fourier transform for the estimation of power spectra: a method based on time averaging over short, modified periodograms. IEEE Trans Audio Electroacoust1967; AU-15: 70–73.10.1109/TAU.1967.1161901Search in Google Scholar
[18] Davies LC, Francis D, Jurak P, Kara I, Piepoli M, Coats AJ. Reproducibility of methods for assessing baroreflex sensitivity in normal controls and in patients with chronic heart failure. Clin Sci (Lond)1999; 97: 515–522.10.1042/CS19990135Search in Google Scholar
[19] Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation1991; 84: 482–492.10.1161/01.CIR.84.2.482Search in Google Scholar
[20] Persson PB, DiRienzo M, Castiglioni P, et al. Time versus frequency domain techniques for assessing baroreflex sensitivity. J Hypertens2001; 19: 1699–1705.10.1097/00004872-200110000-00001Search in Google Scholar
[21] Pitzalis MV, Mastropasqua F, Massari F, et al. Effect of respiratory rate on the relationships between RR interval and systolic blood pressure fluctuations: a frequency-dependent phenomenon. Cardiovasc Res1998; 38: 332–339.10.1016/S0008-6363(98)00029-7Search in Google Scholar
[22] Taylor JA, Carr DL, Myers CW, Eckberg DL. Mechanisms underlying very-low-frequency RR-interval oscillations in humans. Circulation1998; 98: 547–555.10.1161/01.CIR.98.6.547Search in Google Scholar PubMed
[23] Pagani M, Somers V, Furlan R, et al. Changes in autonomic regulation induced by physical training in mild hypertension. Hypertension1988; 12: 600–610.10.1161/01.HYP.12.6.600Search in Google Scholar
[24] de Boer RW, Karemaker JM, Strackee J. Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model. Am J Physiol1987; 253: H680–H689.10.1152/ajpheart.1987.253.3.H680Search in Google Scholar PubMed
[25] Saul JP, Berger RD, Albrecht P, Stein SP, Chen MH, Cohen RJ. Transfer function analysis of the circulation: unique insights into cardiovascular regulation. Am J Physiol1991; 261: H1231–H1245.10.1152/ajpheart.1991.261.4.H1231Search in Google Scholar PubMed
[26] Hughson RL, Quintin L, Annat G, Yamamoto Y, Gharib C. Spontaneous baroreflex by sequence and power spectral methods in humans. Clin Physiol1993; 13: 663–676.10.1111/j.1475-097X.1993.tb00481.xSearch in Google Scholar PubMed
[27] Cooke WH, Cox JF, Diedrich AM, et al. Controlled breathing protocols probe human autonomic cardiovascular rhythms. Am J Physiol1998; 274: H709–H718.10.1152/ajpheart.1998.274.2.H709Search in Google Scholar PubMed
[28] Garet M, Barthelemy JC, Degache F, Pichot V, Duverney D, Roche F. Modulations of human autonomic function induced by positive pressure-assisted breathing. Clin Physiol Funct Imaging2006; 26: 15–20.10.1111/j.1475-097X.2005.00645.xSearch in Google Scholar PubMed
[29] Pitzalis MV, Mastropasqua F, Passantino A, et al. Comparison between noninvasive indices of baroreceptor sensitivity and the phenylephrine method in post-myocardial infarction patients. Circulation1998; 97: 1362–1367.10.1161/01.CIR.97.14.1362Search in Google Scholar PubMed
[30] Seals DR, Suwarno NO, Dempsey JA. Influence of lung volume on sympathetic nerve discharge in normal humans. Circ Res1990; 67: 130–141.10.1161/01.RES.67.1.130Search in Google Scholar
[31] Becker HF, Jerrentrup A, Ploch T, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation2003; 107: 68–73.10.1161/01.CIR.0000042706.47107.7ASearch in Google Scholar
[32] Sin DD, Logan AG, Fitzgerald FS, Liu PP, Bradley TD. Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation2000; 102: 61–66.10.1161/01.CIR.102.1.61Search in Google Scholar
[33] Brooks D, Horner RL, Floras JS, Kozar LF, Render-Teixeira CL, Phillipson EA. Baroreflex control of heart rate in a canine model of obstructive sleep apnea. Am J Respir Crit Care Med1999; 159: 1293–1297.10.1164/ajrccm.159.4.9806114Search in Google Scholar PubMed
[34] Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest1995; 96: 1897–1904.10.1172/JCI118235Search in Google Scholar PubMed PubMed Central
[35] Denault AY, Gorcsan J III, Pinsky MR. Dynamic effects of positive-pressure ventilation on canine left ventricular pressure-volume relations. J Appl Physiol2001; 91: 298–308.10.1152/jappl.2001.91.1.298Search in Google Scholar PubMed
[36] Desai TH, Collins JC, Snell M, Mosqueda-Garcia R. Modeling of arterial and cardiopulmonary baroreflex control of heart rate. Am J Physiol1997; 272: H2343–H2352.10.1152/ajpheart.1997.272.5.H2343Search in Google Scholar PubMed
[37] Heindl S, Dodt C, Krahwinkel M, Hasenfuss G, Andreas S. Short term effect of continuous positive airway pressure on muscle sympathetic nerve activity in patients with chronic heart failure. Heart2001; 85: 185–190.10.1136/heart.85.2.185Search in Google Scholar PubMed PubMed Central
[38] Pagani M, Montano N, Porta A, et al. Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. Circulation1997; 95: 1441–1448.10.1161/01.CIR.95.6.1441Search in Google Scholar PubMed
[39] Taylor JA, Eckberg DL. Fundamental relations between short-term RR interval and arterial pressure oscillations in humans. Circulation1996; 93: 1527–1532.10.1161/01.CIR.93.8.1527Search in Google Scholar
©2007 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Ralph Mueller and Herbert Witte join the Associate Editor team of Biomedizinische Technik/Biomedical Engineering
- Technological innovations in information engineering demand sustained updating and upgrading in biosignal processing applications: a continual renaissance
- Predicting initiation and termination of atrial fibrillation from the ECG
- Predicting the QRS complex and detecting small changes using principal component analysis
- The role of independent component analysis in the signal processing of ECG recordings
- Implantable cardioverter defibrillator algorithms: status review in terms of computational cost
- Assessment of dynamic changes in cerebral autoregulation
- Corrected body surface potential mapping
- Autonomic cardiac control in animal models of cardiovascular diseases. I. Methods of variability analysis
- Autonomic cardiac control in animal models of cardiovascular diseases II. Variability analysis in transgenic rats with α-tropomyosin mutations Asp175Asn and Glu180Gly
- Fetal ECG extraction during labor using an adaptive maternal beat subtraction technique
- Heart rate variability in the fetus: a comparison of measures
- Estimation of spontaneous baroreflex sensitivity using transfer function analysis: effects of positive pressure ventilation
- Mobile nocturnal long-term monitoring of wheezing and cough
- Vigilance monitoring – review and practical aspects
- Coupled oscillators for modeling and analysis of EEG/MEG oscillations
- Auditory evoked potentials for the assessment of depth of anaesthesia: different configurations of artefact detection algorithms
- NeuMonD: a tool for the development of new indicators of anaesthetic effect
- Recording of focal direct current (DC) changes in the human cerebral cortex using refined non-invasive DC-EEG methodology
- Comparing a template approach and complex bandpass filtering for single-trial analysis of auditory evoked M100
- Wavelet-based analysis of MMN responses in children
- Branched EMG electrodes for stable and selective recording of single motor unit potentials in humans
- EMG analysis of the thenar muscles as a model for EMG-triggered larynx stimulation
- Physiological MR signal variations within the brain at 3 T
- Application of decorrelation-independent component analysis to biomagnetic multi-channel measurements
- A method for locating gradual changes in time series
- The use of digital signal processors (DSPs) in real-time processing of multi-parametric bioelectronic signals
- Steps towards a miniaturized, robust and autonomous measurement device for the long-term monitoring of patient activity: ActiBelt
- Motor timing and more – additional options using advanced registration and evaluation of tapping data
- Cellular signaling: aspects for tumor diagnosis and therapy
- List of reviewers engaged in the Special Issues on Biosignal Processing
- Stellungnahme zu „In vitro Langzeitkultur von humanem Knochen unter physiologischen Lastbedingungen“; Biomed Tech 2004; 49: 364–367
Articles in the same Issue
- Ralph Mueller and Herbert Witte join the Associate Editor team of Biomedizinische Technik/Biomedical Engineering
- Technological innovations in information engineering demand sustained updating and upgrading in biosignal processing applications: a continual renaissance
- Predicting initiation and termination of atrial fibrillation from the ECG
- Predicting the QRS complex and detecting small changes using principal component analysis
- The role of independent component analysis in the signal processing of ECG recordings
- Implantable cardioverter defibrillator algorithms: status review in terms of computational cost
- Assessment of dynamic changes in cerebral autoregulation
- Corrected body surface potential mapping
- Autonomic cardiac control in animal models of cardiovascular diseases. I. Methods of variability analysis
- Autonomic cardiac control in animal models of cardiovascular diseases II. Variability analysis in transgenic rats with α-tropomyosin mutations Asp175Asn and Glu180Gly
- Fetal ECG extraction during labor using an adaptive maternal beat subtraction technique
- Heart rate variability in the fetus: a comparison of measures
- Estimation of spontaneous baroreflex sensitivity using transfer function analysis: effects of positive pressure ventilation
- Mobile nocturnal long-term monitoring of wheezing and cough
- Vigilance monitoring – review and practical aspects
- Coupled oscillators for modeling and analysis of EEG/MEG oscillations
- Auditory evoked potentials for the assessment of depth of anaesthesia: different configurations of artefact detection algorithms
- NeuMonD: a tool for the development of new indicators of anaesthetic effect
- Recording of focal direct current (DC) changes in the human cerebral cortex using refined non-invasive DC-EEG methodology
- Comparing a template approach and complex bandpass filtering for single-trial analysis of auditory evoked M100
- Wavelet-based analysis of MMN responses in children
- Branched EMG electrodes for stable and selective recording of single motor unit potentials in humans
- EMG analysis of the thenar muscles as a model for EMG-triggered larynx stimulation
- Physiological MR signal variations within the brain at 3 T
- Application of decorrelation-independent component analysis to biomagnetic multi-channel measurements
- A method for locating gradual changes in time series
- The use of digital signal processors (DSPs) in real-time processing of multi-parametric bioelectronic signals
- Steps towards a miniaturized, robust and autonomous measurement device for the long-term monitoring of patient activity: ActiBelt
- Motor timing and more – additional options using advanced registration and evaluation of tapping data
- Cellular signaling: aspects for tumor diagnosis and therapy
- List of reviewers engaged in the Special Issues on Biosignal Processing
- Stellungnahme zu „In vitro Langzeitkultur von humanem Knochen unter physiologischen Lastbedingungen“; Biomed Tech 2004; 49: 364–367