© 2001 European Society of Cardiology
Altered baroreflex gain during voluntary breathing in chronic heart failure
a Pharmacologie Clinique, Hôpital Henri Mondor Créteil, France
b INRIA-Rocquencourt Le Chesnay, France
c Fédération de Cardiologie, Hôpital Henri Mondor Créteil, France
d INSERM-U127, Hôpital Lariboisière Paris, France
* Corresponding author. Present address: Service de Pneumologie, Unité de Réanimation et Laboratoire de Physiopathologie Respiratoire, Groupe Hospitalier Pitié Salpétrière, 47–83 Boulevard de l'Hôpital, Paris 75651, France. Tel.: +33-1-42176751; fax: +33-1-42176787. E-mail address: laurence.mangin{at}psl.ap-hop-paris.fr (L. Mangin).
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Abstract |
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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 VO2, 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.
Key Words: Heart Failure • Respiration • Baroreflex • Autonomic nervous system • Central nervous system
Received September 15, 2000; Revised October 31, 2000; Accepted November 30, 2000
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