Document Detail


Increased pulse wave velocity and not reduced ejection fraction is associated with impaired baroreflex control of heart rate in congestive heart failure.
MedLine Citation:
PMID:  20577129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is known that baroreflex sensitivity (BRS) is impaired in cardiac patients with myocardial infarction (MI). Nevertheless, it is unknown whether factors other than a reduced ejection fraction play a role in the baroreflex impairment of these patients.
METHODS AND RESULTS: Heart failure patients [congestive heart failure (CHF), n = 31, age 63 +/- 1.2 years, mean +/- SEM)], age-matched controls (n = 29) and coronary artery disease (CAD) patients without MI (n = 29) had RR interval and arterial blood pressure (BP) continuously monitored. Baroreflex function was assessed by the slope of the regression of RR interval, and BP responses to graded (-10, -20 and -40 mmHg) neck suction stimulation, the slope of bradycardic or tachycardic responses to spontaneous increases or reductions of SBP (sequence analysis) and the baroreflex efficiency index. Pulse wave velocity (PWV) was also measured.Compared with controls, CHF patients had RR interval and BP reflex responses to neck suction reduced by -36 and -54%, respectively (P < 0.01). By contrast, no differences were found between CHF and CAD patients. Similar reductions were observed for the sequence analysis (P < 0.01) in both CHF and CAD patients. Multiple regression analysis showed that in CHF and CAD patients, PWV and SBP and not ejection fraction were correlated with BRS.
CONCLUSION: The baroreflex function is impaired in CHF patients, the extent and the degree of baroreflex impairment being similar to that of CAD patients without MI. In CHF and CAD patients, the baroreflex impairment correlates significantly with the increased PWV and not with ejection fraction.
Authors:
Alberto Radaelli; Paolo Castiglioni; Giulia Balestri; Francesca Cesana; Caterina De Carlini; Francesco Soriano; Arianna Azzellino; Marco Di Rienzo; Giovanni Paolini; Alberto U Ferrari; Giuseppe Mancia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-11     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1908-12     Citation Subset:  IM    
Affiliation:
Division of Cardiac Rehabilitation, Ospedale San Gerardo, Monza, Italy. alberto.radaelli@hsgerardo.org
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MeSH Terms
Descriptor/Qualifier:
Baroreflex / physiology*
Blood Pressure / physiology
Case-Control Studies
Coronary Disease / physiopathology
Heart Failure / physiopathology*
Heart Rate / physiology*
Humans
Middle Aged
Pulsatile Flow / physiology
Regression Analysis
Stroke Volume / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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