Reproducibility of methods for assessing baroreflex sensitivity in normal controls and in patients with chronic heart failure
Reproducibility of methods for assessing baroreflex sensitivity in normal controls and in patients with chronic heart failure
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DOI：
10.1042/cs19990135
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发表时间：
1999-10-01
期刊：
影响因子：
6
通讯作者：
Coats, AJS
中科院分区：
文献类型：
--
作者：
Davies, LC;Francis, DP;Coats, AJS
压力反射敏感性（BRS）在心脏病患者中传达有用的预后信息，但其定量方法在一些心力衰竭患者中具有差的再现性和测试失败。本研究旨在比较四种不同的BRS评估方法在正常人和慢性心力衰竭（CHF）患者中的短期重现性和成功率。共31名CHF患者和18名正常对照使用四种技术进行了BRS测试：（1）推注苯肾上腺素（BRSPhe），（2）低频和高频带的α指数（分别为BRSalpha LF和BRSalpha HF），（3）序列方法（BRSSeq）和（4）新的0.1 Hz控制呼吸时域分析方法（BRSCbr）。每名受试者在同一天使用每种方法进行两次测试。患者和对照组的BRS平均值分别为：BRSPhe，4.4（+/-4.4）ms/mmHg和19.8（+/-11.5）ms/mmHg; BRSalpha LF，5.6（+/-4. 1)ms/mmHg和15.4（+/- 5.0）ms/mmHg; BRSalpha HF，7.1（+/- 7.0）ms/mmHg和25.1（+/-8.3）ms/mmHg; BRSeq，7.7（+/-6.3）ms/mmHg和22.5（+/-8.4）ms/mmHg; BRSCbr，6.6（+/-5.9）ms/mmHg和22.8（+/-10.8）ms/mmHg。变异系数（S.D.）患者和对照组的重复值差异（除以平均值）分别为：BRSPhe，85.6%和52.2%; BRSalpha LF，65.9%和33.7%; BRSalpha HF，99.7%和52.1%; BRSSeq，30.7%和40.4%; BRSCbr，30.7%和19.6%。患者中检测失败的数量为：BRSPhen，15例; BRS alpha LF，7例; BRSAlpha HF，5例; BRSSeq，14例; BRSCbr，1例。在评估的四种测量BRS的技术中，控制呼吸时域方法在对照组和CHF患者中具有最佳的重现性和最低的失败率。
Baroreflex sensitivity (BRS) conveys useful prognostic information in patients with heart disease, yet methods for its quantification suffer from poor reproducibility and test failure in some patients with heart failure. We set out to compare the short-term reproducibility and success rate of four different methods of assessing BRS in normal subjects and patients with chronic heart failure (CHF). A total of 31 patients with CHF and 18 normal controls underwent BRS testing using four techniques: (1) bolus phenylephrine (BRSPhe), (2) alpha-index in both low- and high- frequency bands (BRSalpha LF and BRSalpha HF respectively), (3) the sequence method (BRSSeq), and (4) a new 0.1 Hz controlled-breathing, time-domain analysis method (BRSCbr). Each subject underwent two test episodes with each method on the same day. The average values for BRS in patients and controls respectively were: BRSPhe, 4.4 (+/-4.4) ms/mmHg and 19.8 (+/-11.5) ms/mmHg; BRSalpha LF, 5.6 (+/- 4. 1) ms/mmHg and 15.4 (+/- 5.0) ms/mmHg; BRSalpha HF, 7.1 (+/- 7.0) ms/mmHg and 25.1 (+/-8.3) ms/mmHg; BRSSeq, 7.7 (+/-6.3) ms/mmHg and 22.5 (+/-8.4) ms/mmHg; BRSCbr, 6.6 (+/-5.9) ms/mmHg and 22.8 (+/-10.8) ms/mmHg. The coefficients of variation (S.D. of the difference in repeated values divided by mean) in patients and controls respectively were: BRSPhe, 85.6% and 52.2%; BRSalpha LF, 65.9% and 33.7%; BRSalpha HF, 99.7% and 52.1%; BRSSeq, 30.7% and 40.4%; BRSCbr, 30.7% and 19.6%. The numbers of test failures in patients were: BRSPhen, 15; BRS alpha LF, 7; BRSalpha HF, 5; BRSSeq, 14; BRSCbr, 1. Of the four techniques assessed for measuring BRS, the controlled breathing time-domain method yielded the best reproducibility and lowest failure rate in controls and in patients with CHF.