Baroreflex sensitivity assessment and heart rate variability: relation to maneuver and technique

In the present study, we examined two baroreflex sensitivity (BRS) issues that remain uncertain: the differences among diverse BRS assessment techniques and the association between BRS and vagal outflow. Accordingly, the electrocardiogram and non-invasive arterial pressure were recorded in 27 healthy subjects, during supine with and without controlled breathing, standing, exercise, and recovery conditions. Vagal outflow was estimated by heart rate variability indexes, whereas BRS was computed by alpha-coefficient, transfer function, complex demodulation in low- and high-frequency bands, and by sequence technique. Our results indicated that only supine maneuvers showed significantly greater BRS values over the high frequency than in the low-frequency band. For maneuvers at the same frequency region, supine conditions presented a larger number of significant differences among techniques. The plots between BRS and vagal measures depicted a funnel-shaped relationship with significant log-log correlations (r=0.880-0.958). Very short latencies between systolic pressure and RR interval series in high-frequency band and strong log-log correlations between frequency bands were found. Higher variability among different baroreflex measurements was associated with higher level of vagal outflow. Methodological assumptions for each technique seem affected by non-baroreflex variation sources, and a modified responsiveness of vagal motoneurons due to distinct stimulation levels for each maneuver was suggested. Thus, highest vagal outflows corresponded to greatest BRS values, with maximum respiratory effect for the high-frequency band values. In conclusion, BRS values and differences across the tested techniques were strongly related to the vagal outflow induced by the maneuvers.