Comparison between invasive and non-invasive measurements of baroreflex sensitivity. Implications for studies on risk stratification after a myocardial infarction

• Published in: European heart journal 2000-09, Vol.21 (18), p.1522-1529
• Main Authors: Pinna, G.D, La Rovere, M.T, Maestri, R, Mortara, A, Bigger, J.T, Schwartz, P.J
• Format: Article
• Language: English
• Subjects: Autonomic Nervous System - physiopathology; Baroreflex - physiology; Baroreflex sensitivity; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Data Interpretation, Statistical; Female; Finapres; Heart; Humans; Male; Medical sciences; Middle Aged; myocardial infarction; Myocardial Infarction - physiopathology; Phenylephrine - administration & dosage; Predictive Value of Tests; Prognosis; Reproducibility of Results; risk stratification; Sensitivity and Specificity; Signal Processing, Computer-Assisted; Vasoconstrictor Agents - administration & dosage
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.1999.1948

Aims The ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) study has proved the independent prognostic value of baroreflex sensitivity. A limitation of the traditional method of estimating baroreflex sensitivity by phenylephrine, is the need to monitor intra-arterial blood pressure. Our objective was to establish whether this invasive method of monitoring could be superseded by non-invasive methods, such as the Finapres device. Methods and Results Patients with three repeated invasive and non-invasive baroreflex sensitivity measurements were selected from the ATRAMI database (n=454). The mean of these measurements was taken as the baroreflex sensitivity estimate. The repeatability of both methods (standard deviation of the three measurements) decreased with increasing baroreflex sensitivity. There was no constant bias between invasive and non-invasive measurements (0·22±2·2ms.mmHg−1, P=0·42). The linear correlation was very high (r=0·91, P