Abstract
Background: Arterial baroreceptors play a central role in governing autonomic outflow to the heart and are involved in the electrophysiological mechanisms by which sympathetic activation may initiate a ventricular tachyarrhythmia and vagal activation may have antifibrillatory effects. Stimulation of arterial baroreceptors results in sympathoinhibition and efferent vagal activation. Cardiovascular disease may alter baroreceptor function leading to inappropriate or excessive autonomic activity in response to blood pressure changes. Methods: Evidence obtained in an experimental preparation in chronically infarcted dogs opened the way to the understanding of the importance of the analysis of baroreceptor control of heart rate in risk stratification. Among several methodologies, the measurement of the reflex R-R interval lengthening following a blood pressure rise induced by bolus injections of phenylephrine has been shown to provide clinically relevant information as a measure of the capability to augment vagal activity. Results: Following pilot studies conducted by different groups of investigators, the Autonomic Tone and Reflexes After Myocardial Infarction (ATRAMI) trial in a series of 1284 myocardial infarction patients has demonstrated that the prognostic value of baroreflex sensitivity is largely independent from the established clinical predictors Such as left ventricular ejection fraction and ventricular arrhythmias. Conclusions: In these patients, the value of the information obtained by the combination between left ventricular function and baroreflex sensitivity suggests that this analysis should be included in the risk stratification strategy for identification of patients who may need an implantable automatic defibrillator for primary prevention of sudden cardiac death. The analysis of baroreceptor reflexes is of prognostic value also in patients with chronic heart failure.
| Original language | English |
|---|---|
| Pages (from-to) | 219-231 |
| Number of pages | 13 |
| Journal | Annals of Noninvasive Electrocardiology |
| Volume | 4 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1999 |
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Keywords
- Arterial baroreceptors
- Autonomic nervous system
- Heart failure
- Ischemic heart disease
- Phenylephrine
- Sudden cardiac death
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Baroreflex sensitivity. / Rovere, Maria Teresa La.
In: Annals of Noninvasive Electrocardiology, Vol. 4, No. 2, 1999, p. 219-231.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Baroreflex sensitivity
AU - Rovere, Maria Teresa La
PY - 1999
Y1 - 1999
N2 - Background: Arterial baroreceptors play a central role in governing autonomic outflow to the heart and are involved in the electrophysiological mechanisms by which sympathetic activation may initiate a ventricular tachyarrhythmia and vagal activation may have antifibrillatory effects. Stimulation of arterial baroreceptors results in sympathoinhibition and efferent vagal activation. Cardiovascular disease may alter baroreceptor function leading to inappropriate or excessive autonomic activity in response to blood pressure changes. Methods: Evidence obtained in an experimental preparation in chronically infarcted dogs opened the way to the understanding of the importance of the analysis of baroreceptor control of heart rate in risk stratification. Among several methodologies, the measurement of the reflex R-R interval lengthening following a blood pressure rise induced by bolus injections of phenylephrine has been shown to provide clinically relevant information as a measure of the capability to augment vagal activity. Results: Following pilot studies conducted by different groups of investigators, the Autonomic Tone and Reflexes After Myocardial Infarction (ATRAMI) trial in a series of 1284 myocardial infarction patients has demonstrated that the prognostic value of baroreflex sensitivity is largely independent from the established clinical predictors Such as left ventricular ejection fraction and ventricular arrhythmias. Conclusions: In these patients, the value of the information obtained by the combination between left ventricular function and baroreflex sensitivity suggests that this analysis should be included in the risk stratification strategy for identification of patients who may need an implantable automatic defibrillator for primary prevention of sudden cardiac death. The analysis of baroreceptor reflexes is of prognostic value also in patients with chronic heart failure.
AB - Background: Arterial baroreceptors play a central role in governing autonomic outflow to the heart and are involved in the electrophysiological mechanisms by which sympathetic activation may initiate a ventricular tachyarrhythmia and vagal activation may have antifibrillatory effects. Stimulation of arterial baroreceptors results in sympathoinhibition and efferent vagal activation. Cardiovascular disease may alter baroreceptor function leading to inappropriate or excessive autonomic activity in response to blood pressure changes. Methods: Evidence obtained in an experimental preparation in chronically infarcted dogs opened the way to the understanding of the importance of the analysis of baroreceptor control of heart rate in risk stratification. Among several methodologies, the measurement of the reflex R-R interval lengthening following a blood pressure rise induced by bolus injections of phenylephrine has been shown to provide clinically relevant information as a measure of the capability to augment vagal activity. Results: Following pilot studies conducted by different groups of investigators, the Autonomic Tone and Reflexes After Myocardial Infarction (ATRAMI) trial in a series of 1284 myocardial infarction patients has demonstrated that the prognostic value of baroreflex sensitivity is largely independent from the established clinical predictors Such as left ventricular ejection fraction and ventricular arrhythmias. Conclusions: In these patients, the value of the information obtained by the combination between left ventricular function and baroreflex sensitivity suggests that this analysis should be included in the risk stratification strategy for identification of patients who may need an implantable automatic defibrillator for primary prevention of sudden cardiac death. The analysis of baroreceptor reflexes is of prognostic value also in patients with chronic heart failure.
KW - Arterial baroreceptors
KW - Autonomic nervous system
KW - Heart failure
KW - Ischemic heart disease
KW - Phenylephrine
KW - Sudden cardiac death
UR - http://www.scopus.com/inward/record.url?scp=0033028707&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033028707&partnerID=8YFLogxK
U2 - 10.1111/j.1542-474X.1999.tb00063.x
DO - 10.1111/j.1542-474X.1999.tb00063.x
M3 - Article
AN - SCOPUS:0033028707
VL - 4
SP - 219
EP - 231
JO - Annals of Noninvasive Electrocardiology
JF - Annals of Noninvasive Electrocardiology
SN - 1082-720X
IS - 2
ER -