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(Circulation. 2002;105:143.)
© 2002 American Heart Association, Inc.

Brief Rapid Communications

Slow Breathing Increases Arterial Baroreflex Sensitivity in Patients With Chronic Heart Failure

Luciano Bernardi, MD; Cesare Porta, MD; Lucia Spicuzza, MD; Jerzy Bellwon, MD; Giammario Spadacini, MD; Axel W. Frey, MD; Leata Y.C. Yeung, MD; John E. Sanderson, MD; Roberto Pedretti, MD; Roberto Tramarin, MD

From the Department of Internal Medicine, University of Pavia and IRCCS Ospedale S Matteo, (L.B., C.P.), Pavia, Italy; the Institute of Respiratory Diseases, University of Catania (L.S.), Catania, Italy; First Department of Cardiology, University of Gdansk (J.B.), Gdansk, Poland; Herz-Zentrum (G.M., A.W.F.), Bad Krozingen, Germany; the Chinese University of Hong Kong, Prince of Wales Hospital (L.Y.C.Y., J.E.S.), Hong Kong SAR; the Department of Cardiology, IRCCS Fondazione Salvatore Maugeri, Centro Medico Tradate (R.P.), Tradate, Italy; and the Department of Cardiology, IRCCS Fondazione Salvatore Maugeri, Centro Medico Pavia (R.T.), Pavia, Italy.

Correspondence to Luciano Bernardi, MD, Clinica Medica 1, Universita’ di Pavia, IRCCS Ospedale S Matteo, 27100 Pavia, Italy. E-mail lbern1ps{at}unipv.it

Background— It is well established that a depressed baroreflex sensitivity may adversely influence the prognosis in patients with chronic heart failure (CHF) and in those with previous myocardial infarction.

Methods and Results— We tested whether a slow breathing rate (6 breaths/min) could modify the baroreflex sensitivity in 81 patients with stable (2 weeks) CHF (age, 58±1 years; NYHA classes I [6 patients], II [33], III [27], and IV [15]) and in 21 controls. Slow breathing induced highly significant increases in baroreflex sensitivity, both in controls (from 9.4±0.7 to 13.8±1.0 ms/mm Hg, P<0.0025) and in CHF patients (from 5.0±0.3 to 6.1±0.5 ms/mm Hg, P<0.0025), which correlated with the value obtained during spontaneous breathing (r=+0.202, P=0.047). In addition, systolic and diastolic blood pressure decreased in CHF patients (systolic, from 117±3 to 110±4 mm Hg, P=0.009; diastolic, from 62±1 to 59±1 mm Hg, P=0.02).

Conclusions— These data suggest that in patients with CHF, slow breathing, in addition to improving oxygen saturation and exercise tolerance as has been previously shown, may be beneficial by increasing baroreflex sensitivity.

Key Words: baroreflex • heart failure • heart rate • blood pressure • respiration

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