Determination of Baroreflex Sensitivity during the Modified Oxford Maneuver by Trigonometric Regressive Spectral Analysis 英文参考文献.docVIP

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Determination of Baroreflex Sensitivity during the Modified Oxford Maneuver by Trigonometric Regressive Spectral Analysis 英文参考文献.doc

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Determination of Baroreflex Sensitivity during the Modified Oxford Maneuver by Trigonometric Regressive Spectral Analysis 英文参考文献

DeterminationofBaroreflexSensitivityduringthe ModifiedOxfordManeuverbyTrigonometricRegressive SpectralAnalysis JuliaGasch1,ManjaReimann1,2*,HeinzReichmann1,HeinzRu¨diger1,2,TjalfZiemssen1,2 1Autonomic and Neuroendocrinological Laboratory, Department of Neurology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany, 2Research Group Neuro-Metabolism, Department of Neurology and Internal Medicine III, University Hospital Carl Gustav Carus, Dresden University of Technology,Dresden,Germany Abstract Background:Differencesinspontaneousanddrug-inducedbaroreflexsensitivity(BRS)havebeenattributedtoitsdifferent operating ranges. The current study attempted to compare BRS estimates during cardiovascular steady-state and pharmacologicallystimulationusinganinnovativealgorithmfordynamicdeterminationofbaroreflexgain. Methodology/PrincipalFindings:Forty-fivevolunteersunderwentthemodifiedOxfordmaneuverinsupineand60utilted positionwithbloodpressureandheartratebeingcontinuouslyrecorded.Drug-inducedBRS-estimateswerecalculatedfrom data obtained by bolus injections of nitroprusside and phenylephrine. Spontaneous indices were derived from data obtained during rest (stationary) and under pharmacological stimulation (non-stationary) using the algorithm of trigonometricregressivespectralanalysis(TRS).Spontaneousanddrug-inducedBRSvaluesweresignificantlycorrelatedand display directionally similar changes under different situations. Using the Bland-Altman method, systematic differences betweenspontaneousanddrug-inducedestimateswerefoundandrevealedthatthediscrepancycanbeaslargeasthe gainitself.Fixedbiaswasnotevidentwithordinaryleastproductsregression.Thecorrelationandagreementbetweenthe estimatesincreasedsignificantlywhenBRSwascalculatedbyTRSinnon-stationarymodeduringthedruginjectionperiod. TRS-BRSsignificantlyincreasedduringphenylephrineanddecreasedundernitroprusside. Conclusions/Significance:TheTRSanalysisprovidesareliable,non-invasiveassessmentofhumanBR