Baroreflex sensitivity as a new marker for risk stratification

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

As the arterial baroreflex importantly contributes to modulation of the autonomic influences on the heart and thereby arrhythmogenesis, baroreflex sensitivity has been used as a measure of the interaction between sympathetic and parasympathetic activities at the cardiac level. The most widely applied technique both in the experimental and clinical setting is the measurement of the heart rate slowing in response to a blood pressure rise induced by small intravenous boluses of phenylephrine. Baroreflex sensitivity is expressed as ms/mmHg and prevailing vagal reflexes are reflected by the wider R-R interval lengthening. The experimental evidence that the occurrence of ventricular fibrillation was inversely related to baroreflex sensitivity, opened the way to clinical studies. The ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) trial has definitely demonstrated not only that a depressed baroreflex sensitivity (<3 ms/mmHg) is a strong risk factor for cardiac death, but also that the information gained by the analysis of autonomic markers adds to the information obtained by better recognized measures of cardiovascular outcome such as left ventricular function and ventricular arrhythmias. The value of a depressed baroreflex sensitivity as a risk stratifier is meaningful in patients below age 65 in combination of a simultaneously depressed left ventricular ejection fraction. In these patients, the analysis of autonomic activity might be of value in the identification of patients who may need an implantable automatic defibrillator for primary prevention of sudden cardiac death.

Original languageEnglish
JournalZeitschrift fur Kardiologie
Volume89
Issue numberSUPPL. 3
Publication statusPublished - 2000

Fingerprint

Baroreflex
Reflex
Implantable Defibrillators
Sudden Cardiac Death
Phenylephrine
Ventricular Fibrillation
Primary Prevention
Left Ventricular Function
Stroke Volume
Cardiac Arrhythmias
Heart Rate
Myocardial Infarction
Outcome Assessment (Health Care)
Blood Pressure

Keywords

  • Arterial baroreceptors
  • Autonomic nervous system
  • Ischemic heart disease
  • Phenylephrine
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Baroreflex sensitivity as a new marker for risk stratification. / La Rovere, Maria Teresa.

In: Zeitschrift fur Kardiologie, Vol. 89, No. SUPPL. 3, 2000.

Research output: Contribution to journalArticle

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