Baroreflex sensitivity assessed by means of the phenylephrine test plays a prognostic role in patients with previous myocardial infarction, but the need for drug injection limits the use of this technique. Recently, several non-invasive methods based on spectral analysis of systolic arterial pressure and heart period have been proposed, but their agreement with the phenylephrine test has not been investigated in patients with heart failure. The two methods (phenylephrine test and spectral analysis) were compared in a group of 49 patients with chronic congestive heart failure both at rest and during controlled breathing. The linear correlation and the limits of agreement between the phenylephrine test slope and the α-index [αc; corrected by the coherence function between the interbeat interval (RR interval) and systolic arterial pressure] were evaluated. Only 16 patients had a measurable α-index at rest in both the low-frequency (LF) and high-frequency (HF) bands; the αc-index allowed measurements in all patients. It correlated moderately with the phenylephrine test slope at rest (r = 0.71 and P< 0.001 in LF; r = 0.57 and P< 0.001 in HF) and during controlled breathing (r = 0.51 and P< 0.001 in LF; r = 0.63 and P< 0.001 in HF). Multivariate regression analysis showed that only αcLF during rest and αcHF during controlled breathing contributed significantly to baroreflex gain estimation. However, the agreement between methods was weak; the normalized limits of agreement and bias were -162 to 243% (0.46 ms/mmHg) for αcLF and -185 to 151% (-0.99 ms/mmHg) for αcHF. Thus the comparison between baroreflex sensitivity measurements obtained by the phenylephrine test and spectral analysis showed a moderate correlation between the two methods; however, despite the linear association, a consistent lack of agreement between the two techniques was found. Because both systematic and random factors contribute to the difference, these two techniques cannot be considered as alternatives for the assessment of heart failure.
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Research Article|
September 17 1999
Comparison between spectral analysis and the phenylephrine method for the assessment of baroreflex sensitivity in chronic heart failure
Roberto COLOMBO;
*‘Salvatore Maugeri’ Foundation, IRCCS, Service of Bioengineering, Veruno (NO), Italy
Correspondence: Dr R. Colombo, Fondazione Salvatore Maugeri, Via Revislate 13, 28010 Veruno (NO), Italy (e-mail [email protected]).
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Giorgio MAZZUERO;
Giorgio MAZZUERO
†Division of Cardiology, Veruno (NO), Italy
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Gianluca SPINATONDA;
Gianluca SPINATONDA
*‘Salvatore Maugeri’ Foundation, IRCCS, Service of Bioengineering, Veruno (NO), Italy
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Paola LANFRANCHI;
Paola LANFRANCHI
†Division of Cardiology, Veruno (NO), Italy
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Pantaleo GIANNUZZI;
Pantaleo GIANNUZZI
†Division of Cardiology, Veruno (NO), Italy
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Piotr PONIKOWSKI;
Piotr PONIKOWSKI
‡Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College, London, U.K.
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Andrew J. S. COATS;
Andrew J. S. COATS
‡Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College, London, U.K.
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Giuseppe MINUCO
Giuseppe MINUCO
*‘Salvatore Maugeri’ Foundation, IRCCS, Service of Bioengineering, Veruno (NO), Italy
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Publisher: Portland Press Ltd
Received:
January 26 1999
Revision Received:
May 20 1999
Accepted:
July 12 1999
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1999) 97 (4): 503–513.
Article history
Received:
January 26 1999
Revision Received:
May 20 1999
Accepted:
July 12 1999
Citation
Roberto COLOMBO, Giorgio MAZZUERO, Gianluca SPINATONDA, Paola LANFRANCHI, Pantaleo GIANNUZZI, Piotr PONIKOWSKI, Andrew J. S. COATS, Giuseppe MINUCO; Comparison between spectral analysis and the phenylephrine method for the assessment of baroreflex sensitivity in chronic heart failure. Clin Sci (Lond) 1 October 1999; 97 (4): 503–513. doi: https://doi.org/10.1042/cs0970503
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