Vascular resistance arm of the baroreflex: methodology and comparison with the cardiac chronotropic arm

Abstract

Baroreflex response consists of cardiac chronotropic (effect on heart rate), cardiac inotropic (on contractility), venous (on venous return) and vascular (on vascular resistance) arms. Because of its measurement simplicity, cardiac chronotropic arm is most often analysed. The aim was to introduce a method to assess vascular baroreflex arm, and to characterize its changes during stress. We evaluated the effect of orthostasis and mental arithmetics (MA) in 39 (22 female, median age: 18.7 yrs.) and 36 (21 female, 19.2 yrs.) healthy volunteers, respectively. We recorded systolic and mean blood pressure (SBP and MBP) by volume-clamp method and R-R interval (RR) by ECG. Cardiac output (CO) was recorded using impedance cardiography. From MBP and CO, peripheral vascular resistance (PVR) was calculated. The directional spectral coupling and gain of cardiac chronotropic (SBP to RR) and vascular arms (SBP to PVR) were quantified. The strength of the causal coupling from SBP to PVR was significantly higher than SBP to RR coupling during whole protocol (P < 0.001). Along both arms, the coupling was higher during orthostasis compared to supine (P < 0.001 and P = 0.006), no MA effect was observed. No significant changes in the spectral gain (ratio of RR or PVR change to a unit SBP change) across all phases were found (0.111 ≤ P ≤ 0.907). We conclude that changes in PVR are tightly coupled with SBP oscillations via the baroreflex providing an approach for the baroreflex vascular arm analysis with a potential to reveal new aspects of blood pressure dysregulation.