Arterial baroreflex modulation of Heart rate in chronic heart failure : Clinical and hemodynamic correlates and prognostic implications

In chronic heart failure (CHF), arterial baroreflex regulation of cardiac function is impaired, leading to a reduction in the tonic restraining influence on the sympathetic nervous system. Because baroreflex sensitivity (BRS), as assessed by the phenylephrine technique, significantly contributes to...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1997-11, Vol.96 (10), p.3450-3458
Main Authors: MORTARA, A, LA ROVERE, M. T, PINNA, G. D, PRPA, A, MAESTRI, R, FEBO, O, POZZOLI, M, OPASICH, C, TAVAZZI, L
Format: Article
Language:English
Subjects:
Adult
Arteries - physiopathology
Baroreflex - physiology
Biological and medical sciences
Cardiac Output, Low - mortality
Cardiac Output, Low - physiopathology
Cardiology. Vascular system
Chronic Disease
Heart
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Rate - physiology
Hemodynamics - physiology
Humans
Medical sciences
Middle Aged
Prognosis
Survival Analysis
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Summary:In chronic heart failure (CHF), arterial baroreflex regulation of cardiac function is impaired, leading to a reduction in the tonic restraining influence on the sympathetic nervous system. Because baroreflex sensitivity (BRS), as assessed by the phenylephrine technique, significantly contributes to postinfarction risk stratification, the aim of the present study was to evaluate whether in CHF patients a depressed BRS is associated with a worse clinical hemodynamic status and unfavorable outcome. BRS was assessed in 282 CHF patients in sinus rhythm receiving stable medical therapy (age, 52+/-9 years; New York Heart Association [NYHA] class, 2.4+/-0.6; left ventricular ejection fraction [LVEF], 23+/-6%). The BRS of the entire population averaged 3.9+/-4.0 ms/mm Hg (mean+/-SD) and was significantly related to LVEF and hemodynamic parameters (LVEF, P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.96.10.3450