Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients
1 Cardiology Department, Leiden University Medical Center, Leiden; and 2 Department of Physics and Medical Technology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands Submitted 7 February 2006 ; accepted in final form 11 December 2006 The arterial baroreflex buffers slow (
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| Veröffentlicht in: | Journal of applied physiology (1985) 2007-04, Vol.102 (4), p.1348-1356 |
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| container_title | Journal of applied physiology (1985) |
| container_volume | 102 |
| creator | van de Vooren, Hedde Gademan, Maaike G. J Swenne, Cees A TenVoorde, Ben J Schalij, Martin J Van der Wall, Ernst E |
| description | 1 Cardiology Department, Leiden University Medical Center, Leiden; and 2 Department of Physics and Medical Technology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
Submitted 7 February 2006
; accepted in final form 11 December 2006
The arterial baroreflex buffers slow ( |
| doi_str_mv | 10.1152/japplphysiol.00158.2006 |
| format | Article |
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Submitted 7 February 2006
; accepted in final form 11 December 2006
The arterial baroreflex buffers slow (<0.05 Hz) blood pressure (BP) fluctuations, mainly by controlling peripheral resistance. Baroreflex sensitivity (BRS), an important characteristic of baroreflex control, is often noninvasively assessed by relating heart rate (HR) fluctuations to BP fluctuations; more specifically, spectral BRS assessment techniques focus on the BP-to-HR transfer function around 0.1 Hz. Skepticism about the relevance of BRS to characterize baroreflex-mediated BP buffering is based on two considerations: 1 ) baroreflex-modulated peripheral vasomotor function is not necessarily related to baroreflex-HR transfer; and 2 ) although BP fluctuations around 0.1 Hz (Mayer waves) might be related to baroreflex BP buffering, they are merely a not-intended side effect of a closed-loop control system. To further investigate the relationship between BRS and baroreflex-mediated BP buffering, we set up a computer model of baroreflex BP control to simulate normal subjects and heart failure patients. Output variables for various randomly chosen combinations of feedback gains in the baroreflex arms were BP resonance, BP-buffering capacity, and BRS. Our results show that BP buffering and BP resonance are related expressions of baroreflex BP control and depend strongly on the sympathetic gain to the peripheral resistance. BRS is almost uniquely determined by the vagal baroreflex gain to the sinus node. In conclusion, BP buffering and BRS are unrelated unless coupled gains in all baroreflex limbs are assumed. Hence, the clinical benefit of a high BRS is most likely to be attributed to vagal effects on the heart instead of to effective BP buffering.
autonomic nervous system; cardiovascular variability; Mayer waves; spectral analysis; transfer function
Address for reprint requests and other correspondence: C. A. Swenne, Dept. of Cardiology, Leiden Univ. Medical Center, PO Box 9600, 2300 RC Leiden, Netherlands (e-mail: c.a.swenne{at}lumc.nl )</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.00158.2006</identifier><identifier>PMID: 17185500</identifier><identifier>CODEN: JAPHEV</identifier><language>eng</language><publisher>Bethesda, MD: Am Physiological Soc</publisher><subject>Algorithms ; Autonomic Nervous System - physiology ; Baroreflex - physiology ; Biological and medical sciences ; Biological Clocks - physiology ; Blood pressure ; Blood Pressure - physiology ; Cardiac Output, Low - diagnosis ; Cardiac Output, Low - physiopathology ; Computer Simulation ; Diagnosis, Computer-Assisted - methods ; Fundamental and applied biological sciences. Psychology ; Heart - innervation ; Heart - physiology ; Heart failure ; Heart rate ; Heart Rate - physiology ; Humans ; Models, Cardiovascular ; Reference Values ; Sensitivity and Specificity ; Veins & arteries</subject><ispartof>Journal of applied physiology (1985), 2007-04, Vol.102 (4), p.1348-1356</ispartof><rights>2007 INIST-CNRS</rights><rights>Copyright American Physiological Society Apr 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4126-ac3ec709ac872b36e7dda3aa84ede7a277f7a46f9cbf24f2e7ab841061071bf03</citedby><cites>FETCH-LOGICAL-c4126-ac3ec709ac872b36e7dda3aa84ede7a277f7a46f9cbf24f2e7ab841061071bf03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3026,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18734720$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17185500$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van de Vooren, Hedde</creatorcontrib><creatorcontrib>Gademan, Maaike G. J</creatorcontrib><creatorcontrib>Swenne, Cees A</creatorcontrib><creatorcontrib>TenVoorde, Ben J</creatorcontrib><creatorcontrib>Schalij, Martin J</creatorcontrib><creatorcontrib>Van der Wall, Ernst E</creatorcontrib><title>Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>1 Cardiology Department, Leiden University Medical Center, Leiden; and 2 Department of Physics and Medical Technology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
Submitted 7 February 2006
; accepted in final form 11 December 2006
The arterial baroreflex buffers slow (<0.05 Hz) blood pressure (BP) fluctuations, mainly by controlling peripheral resistance. Baroreflex sensitivity (BRS), an important characteristic of baroreflex control, is often noninvasively assessed by relating heart rate (HR) fluctuations to BP fluctuations; more specifically, spectral BRS assessment techniques focus on the BP-to-HR transfer function around 0.1 Hz. Skepticism about the relevance of BRS to characterize baroreflex-mediated BP buffering is based on two considerations: 1 ) baroreflex-modulated peripheral vasomotor function is not necessarily related to baroreflex-HR transfer; and 2 ) although BP fluctuations around 0.1 Hz (Mayer waves) might be related to baroreflex BP buffering, they are merely a not-intended side effect of a closed-loop control system. To further investigate the relationship between BRS and baroreflex-mediated BP buffering, we set up a computer model of baroreflex BP control to simulate normal subjects and heart failure patients. Output variables for various randomly chosen combinations of feedback gains in the baroreflex arms were BP resonance, BP-buffering capacity, and BRS. Our results show that BP buffering and BP resonance are related expressions of baroreflex BP control and depend strongly on the sympathetic gain to the peripheral resistance. BRS is almost uniquely determined by the vagal baroreflex gain to the sinus node. In conclusion, BP buffering and BRS are unrelated unless coupled gains in all baroreflex limbs are assumed. Hence, the clinical benefit of a high BRS is most likely to be attributed to vagal effects on the heart instead of to effective BP buffering.
autonomic nervous system; cardiovascular variability; Mayer waves; spectral analysis; transfer function
Address for reprint requests and other correspondence: C. A. Swenne, Dept. of Cardiology, Leiden Univ. Medical Center, PO Box 9600, 2300 RC Leiden, Netherlands (e-mail: c.a.swenne{at}lumc.nl )</description><subject>Algorithms</subject><subject>Autonomic Nervous System - physiology</subject><subject>Baroreflex - physiology</subject><subject>Biological and medical sciences</subject><subject>Biological Clocks - physiology</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Cardiac Output, Low - diagnosis</subject><subject>Cardiac Output, Low - physiopathology</subject><subject>Computer Simulation</subject><subject>Diagnosis, Computer-Assisted - methods</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heart - innervation</subject><subject>Heart - physiology</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Models, Cardiovascular</subject><subject>Reference Values</subject><subject>Sensitivity and Specificity</subject><subject>Veins & arteries</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdGK1DAUhoso7rj6ChoEBWFnTNKk6XojOrgqLHizXofT9mSaMdPUJHV3nsTXNd0ZGBHMTeCc7z__4fxF8YLRFWOSv93COLqx30fr3YpSJusVp7R6UCxyly9ZRdnDYlErSZdK1uqseBLjNnNCSPa4OGOK1VJSuih-f4TgAxqHdyTiEG2yv2zaX5DGed-RMWCMU0DSTMZgsMPmgsDQkVz2AwwtviO3PSQCGUk9EmeHH_E9WfvdOCUMJNrd5CBZPxBvSI_gUr8ncWq22KZ4PyoXQyIGrJt9xgzjkOLT4pEBF_HZ8T8vvl99ull_WV5_-_x1_eF62QrGqyW0JbaKXkJbK96UFaqugxKgFtihAq6UUSAqc9k2hgvDc62pBaMVo4o1hpbnxevD3DH4nxPGpHc2tugcDOinqBUtpahElcGX_4BbP4Uh76b5_CpZywypA9QGH2M-qx6D3UHYa0b1HJz-Ozh9H5yeg8vK58fxU7PD7qQ7JpWBV0cAYgvOhHx9G09crUqh-My9OXC93fS3NqA-uvnNfnbPm3AtNCtFnVn5f_Zqcu4G79IsOmn02JnyDy-2ynE</recordid><startdate>200704</startdate><enddate>200704</enddate><creator>van de Vooren, Hedde</creator><creator>Gademan, Maaike G. 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Psychology</topic><topic>Heart - innervation</topic><topic>Heart - physiology</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Models, Cardiovascular</topic><topic>Reference Values</topic><topic>Sensitivity and Specificity</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van de Vooren, Hedde</creatorcontrib><creatorcontrib>Gademan, Maaike G. 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J</au><au>Swenne, Cees A</au><au>TenVoorde, Ben J</au><au>Schalij, Martin J</au><au>Van der Wall, Ernst E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2007-04</date><risdate>2007</risdate><volume>102</volume><issue>4</issue><spage>1348</spage><epage>1356</epage><pages>1348-1356</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><coden>JAPHEV</coden><abstract>1 Cardiology Department, Leiden University Medical Center, Leiden; and 2 Department of Physics and Medical Technology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
Submitted 7 February 2006
; accepted in final form 11 December 2006
The arterial baroreflex buffers slow (<0.05 Hz) blood pressure (BP) fluctuations, mainly by controlling peripheral resistance. Baroreflex sensitivity (BRS), an important characteristic of baroreflex control, is often noninvasively assessed by relating heart rate (HR) fluctuations to BP fluctuations; more specifically, spectral BRS assessment techniques focus on the BP-to-HR transfer function around 0.1 Hz. Skepticism about the relevance of BRS to characterize baroreflex-mediated BP buffering is based on two considerations: 1 ) baroreflex-modulated peripheral vasomotor function is not necessarily related to baroreflex-HR transfer; and 2 ) although BP fluctuations around 0.1 Hz (Mayer waves) might be related to baroreflex BP buffering, they are merely a not-intended side effect of a closed-loop control system. To further investigate the relationship between BRS and baroreflex-mediated BP buffering, we set up a computer model of baroreflex BP control to simulate normal subjects and heart failure patients. Output variables for various randomly chosen combinations of feedback gains in the baroreflex arms were BP resonance, BP-buffering capacity, and BRS. Our results show that BP buffering and BP resonance are related expressions of baroreflex BP control and depend strongly on the sympathetic gain to the peripheral resistance. BRS is almost uniquely determined by the vagal baroreflex gain to the sinus node. In conclusion, BP buffering and BRS are unrelated unless coupled gains in all baroreflex limbs are assumed. Hence, the clinical benefit of a high BRS is most likely to be attributed to vagal effects on the heart instead of to effective BP buffering.
autonomic nervous system; cardiovascular variability; Mayer waves; spectral analysis; transfer function
Address for reprint requests and other correspondence: C. A. Swenne, Dept. of Cardiology, Leiden Univ. Medical Center, PO Box 9600, 2300 RC Leiden, Netherlands (e-mail: c.a.swenne{at}lumc.nl )</abstract><cop>Bethesda, MD</cop><pub>Am Physiological Soc</pub><pmid>17185500</pmid><doi>10.1152/japplphysiol.00158.2006</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Physiological Society; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Algorithms Autonomic Nervous System - physiology Baroreflex - physiology Biological and medical sciences Biological Clocks - physiology Blood pressure Blood Pressure - physiology Cardiac Output, Low - diagnosis Cardiac Output, Low - physiopathology Computer Simulation Diagnosis, Computer-Assisted - methods Fundamental and applied biological sciences. Psychology Heart - innervation Heart - physiology Heart failure Heart rate Heart Rate - physiology Humans Models, Cardiovascular Reference Values Sensitivity and Specificity Veins & arteries |
| title | Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients |
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