Dawson SL, Panerai RB, Potter JF
University Department of Medicine for the Elderly, The Glenfield Hospital, Leicester, UK.
Blood Press Monit. 1998 Oct;3(5):315-320.
Cardiac baroreceptor sensitivity (BRS) can now be calculated non-invasively with the advent of new beat-to-beat blood pressure monitors and simulatneous surface electrocardiographic recording. However, it is not known whether BRS values calculated using a pulse interval obtained from the pulse wave are different from those using the electrocardiographic trace. This is important with the advent of new portable monitors (e.g. Portapres), which do not record a simultaneous electrocardiographic trace. OBJECTIVE: To determine whether pulse interval derivations from pulse wave data and electrocardiographic data are comparable.METHODS: Twenty healthy volunteers (10 men) aged 48 +/- 17 years with mean blood pressure 134 +/- 13/77 +/- 7 mmHg were examined. Supine beat-to-beat arterial blood pressure (measured using a Finapres 2300 device from Ohmeda) and surface electrocardiographic readings were recorded and spectral analysis, using fast Fourier transformation (FFT), and sequence analysis used to calculate BRS. Pulse interval was marked using both electrocardiographic and blood pressure traces and we compared the resulting variability of pulse interval and BRS values obtained using the two methodologies. RESULTS: There was good agreement between the two methods for pulse interval power in the low-frequency bandwidth and for BRS sequence analysis, especially for 'down' sequences, (limits of agreement -26.3 to 77.1 ms2 and -1.6 to 2.7 ms/mmHg, respectively). However, in the high frequency bandwidth (0.15-0.35 Hz) and for the combined BRS, the agreement was less good (-69 to 153.8 ms2 and -0.3 to 1.5 ms/mmHg). Overall differences between methods were smaller for BRS calculated in the low frequency rather than high-frequency band, but only in the low-frequency band was the difference positively correlated to mean BRS values. CONCLUSION: Cardiac BRS values calculated using pulse intervals derived from the pulse wave are different from those on the surface electrocardiographic trace, the greatest differences occurring in BRS derived from the high-frequency bandwidth. However, these differences are small, especially in the low-frequency band at lower mean BRS values, and should not discourage use of these newer methods of BRS measurement that do not involve an electrocardiographic recording.
随着新型逐搏血压监测仪和同步体表心电图记录技术的出现，现在可以无创地计算心脏压力感受器敏感性（BRS）。然而，尚不清楚使用脉搏波获得的脉搏间期计算出的BRS值与使用心电图描记计算出的BRS值是否不同。随着新型便携式监测仪（如Portapres）的出现，这一点变得很重要，因为这些监测仪不记录同步心电图描记。目的：确定从脉搏波数据和心电图数据得出的脉搏间期是否具有可比性。方法：对20名年龄48±17岁、平均血压为134±13/77±7 mmHg的健康志愿者（10名男性）进行检查。记录仰卧位逐搏动脉血压（使用Ohmeda公司的Finapres 2300设备测量）和体表心电图读数，并使用快速傅里叶变换（FFT）进行频谱分析，以及使用序列分析来计算BRS。使用心电图和血压描记标记脉搏间期，并比较使用两种方法获得的脉搏间期变异性和BRS值。结果：两种方法在低频带宽下的脉搏间期功率以及BRS序列分析方面，尤其是“下降”序列方面，一致性良好（一致性界限分别为-26.3至77.1 ms²和-1.6至2.7 ms/mmHg）。然而，在高频带宽（0.15 - 0.35 Hz）以及综合BRS方面，一致性较差（-69至153.8 ms²和-0.3至1.5 ms/mmHg）。方法之间的总体差异在低频段计算的BRS中比在高频段小，但仅在低频段差异与平均BRS值呈正相关。结论：使用从脉搏波得出的脉搏间期计算出的心脏BRS值与体表心电图描记得出的不同，最大差异出现在高频带宽得出的BRS中。然而，这些差异较小，尤其是在较低平均BRS值的低频段，并且不应阻碍使用这些不涉及心电图记录的BRS测量新方法。
