School of Medicine, University of Zagreb, Zagreb, Croatia.
University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
J Neurol Sci. 2021 Jul 15;426:117473. doi: 10.1016/j.jns.2021.117473. Epub 2021 Apr 30.
In order to further evaluate clinical usefulness of α- and β-adrenergic components of the baroreflex sensitivity (BRS) index, the aim of this study was to compare them to standardized measures of the autonomic dysfunction.
In 275 participants (mean age 40.57 ± 15.19, range 18 to 89 years, 76.4% females) referred for testing of the autonomic nervous system, α-BRSa, β-BRSa and BRSv were compared to heart rate (HR) and blood pressure (BP) values, adrenergic and cardiovagal indices of the Composite Autonomic Severity Score (CASS) and heart rate variability (HRV) parameters.
α-BRSa showed statistically significant positive correlation with HR in the supine position and negative with the adrenergic index. β-BRSa showed statistically significant negative correlation with tests for parasympathetic nervous system function. BRSv showed statistically significant negative correlation with all HR and BP parameters and positive with all HRV parameters. In a univariable logistic regression analysis, α-BRSa was a negative predictor (Exp(B) 0.866, 95% CI 0.782-0.959, p = 0.006, respectively) of the pathological adrenergic index. To differentiate between subjects with normal and pathological adrenergic index, the optimal cutoff for α-BRSa was found to be 6.741, which gave a sensitivity of 61.0% and a specificity of 56.0%.
BRSa indices showed a good correlation with standard measures of ANS function. The most promising test was α-BRSa, which performed well as a α adrenergic receptors mediated sympathetic nervous system marker.
为了进一步评估压力反射敏感性（BRS）指数的α-和β-肾上腺素能成分的临床实用性，本研究旨在将其与自主神经功能障碍的标准化测量进行比较。
在 275 名（平均年龄 40.57±15.19 岁，范围 18 至 89 岁，76.4%为女性）因自主神经系统测试而就诊的参与者中，比较了α-BRSa、β-BRSa 和 BRSv 与心率（HR）和血压（BP）值、复合自主严重程度评分（CASS）的肾上腺素能和心脏迷走神经指数以及心率变异性（HRV）参数。
α-BRSa 与卧位 HR 呈显著正相关，与肾上腺素能指数呈负相关。β-BRSa 与副交感神经功能测试呈显著负相关。BRSv 与所有 HR 和 BP 参数呈显著负相关，与所有 HRV 参数呈显著正相关。在单变量逻辑回归分析中，α-BRSa 是病理性肾上腺素能指数的负预测因子（Exp（B）0.866，95%CI 0.782-0.959，p=0.006）。为了区分正常和病理性肾上腺素能指数的受试者，发现 α-BRSa 的最佳截断值为 6.741，其敏感性为 61.0%，特异性为 56.0%。
BRSa 指数与自主神经功能的标准测量具有良好的相关性。最有前途的测试是α-BRSa，它作为α肾上腺素能受体介导的交感神经系统标志物表现良好。
