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Altered baroreflex gain during voluntary breathing in chronic heart failure
Author(s) -
Mangin L.,
Monti A.,
Médigue C.,
MacquinMavier I.,
Lopes M.E.,
Gueret P.,
Castaigne A.,
Swynghedauw B.,
Mansier P.
Publication year - 2001
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(00)00147-1
Subject(s) - baroreflex , medicine , heart failure , cardiology , breathing , blood pressure , periodic breathing , respiration , anesthesia , heart rate , anatomy
Background: We assessed the behavior of the baroreflex (BR) gain in chronic heart failure (CHF) patients using the spectral analysis method during application of a forcing stimulus, i.e. respiration. Methods: Simultaneous RR interval and arterial pressure fluctuation recordings were obtained during two random‐order periods of voluntary paced‐breathing (0.15 Hz and 0.25 Hz) in seven patients with moderate CHF (NYHA class II/III; EF, 30 ± 9%; peak VO 2 , 18 ± 5 ml kg −1 min −1 ) and six age‐matched controls. BR gain was assessed in the time (sequential method) and frequency (cross‐spectral gain in the low and high frequency) domains. Results: Slower breathing was associated with a BR gain decrease in CHF patients whereas a BR gain increase was evidenced in controls (BR gain: 6 ± 5 ms mmHg −1 at 0.25 Hz vs. 4 ± 3 ms mmHg −1 at 0.15 Hz, P < 0.05 in CHF; BR gain: 12 ± 7 ms mmHg −1 at 0.25 Hz vs. 15 ± 7 ms mmHg −1 at 0.15 Hz, P < 0.05 in controls). Conclusions: Voluntary breathing, which involves cortical centers in the brain, had major effects on cardiovascular system controller gain in CHF patients, indicating an impairment of the central neural regulation of the autonomic outflow.