[A new, spontaneous method for assessing sympathetic baroreflex function in humans]

Abstract

In humans, assessment of the sympathetic component of the arterial baroreceptor reflex (sBRS) is usually based on microneurographic recordings of muscle sympathetic nerve activity (MSNA), while inducing reflex changes with intravenous administration of vasoactive drugs (modified Oxford method). This method has several limitations, among which its poor temporal resolution. Some studies have proposed alternative methods by using spontaneous changes in arterial pressure (AP) and MSNA, usually collected under baroreflex closed-loop conditions (AP alters MSNA while MSNA alters AP), which makes the results difficult to interpret. In rats, a method has been developed and validated (Kanbar et al., 2007 [1]), which uses oscillations of renal SNA at the frequency of the heart beat. At this frequency, the baroreflex operates under open-loop conditions because of the low-pass filter properties of the resistance vasculature. The goal of the present study was to examine whether this method is applicable in humans. Data were previously collected by Gujic et al. (2007) [2]. Briefly, MSNA and AP were recorded in 16 young healthy subjects during a 5-minute baseline resting period then during a modified Oxford test (sodium nitroprusside and phenylephrine administrations). Using the 5-minute baseline recordings, spontaneous sBRS was assessed through empirical mode decomposition over consecutive 20-second periods. Spontaneous sBRS was significantly related to pharmacological sBRS (R=0.67, n=16, P=0.004). During the 5-minute period, spontaneous sBRS exhibited variations (CV=21.7±1.7%) that were negatively correlated with AP in five subjects (R=-0.61±0.03, P<0.05) and positively correlated with MSNA in ten subjects (R=0.73±0.03, P<0.05). The new method is able to correctly estimate sBRS, and reveals the existence of previously unrecognized fast fluctuations of sBRS.