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From the Institute of Cardiology, University of Bari (M.V.P., L.L., C.B.,
P.R.); the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS,
Rehabilitation Institute of Cassano Murge, Bari (F. Mastropasqua, A.P., F.
Massari, C.F.); and the Division of Cardiology, Institute of Biomedical
Sciences, San Paolo Hospital, University of Milan (F.L.), Italy.
Correspondence to Maria Vittoria Pitzalis, MD, PhD, FESC, Institute of Cardiology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy. E-mail pitzalis{at}mbox.vol.it
Background—Depressed baroreflex
sensitivity obtained by means of a phenylephrine test plays
a prognostic role in patients with a previous myocardial infarction.
Our purpose was to evaluate the correlation and agreement between the
baroreflex sensitivity obtained with phenylephrine and that
obtained by two noninvasive methods: the
Methods and Results—The
Conclusions—The results obtained by means of noninvasive
baroreflex sensitivity assessments should not be used in clinical
practice as an alternative to those obtained by the
phenylephrine method.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Comparison Between Noninvasive Indices of Baroreceptor Sensitivity and the Phenylephrine Method in Post–Myocardial Infarction Patients
-index and sequence
analysis. -index was measured by means of the
spectral analysis of RR and systolic blood pressure
variabilities in both the high- and low-frequency bands; sequences were
identified from simultaneously recorded time series in
which the RR and systolic blood pressure concurrently increased
or decreased. Noninvasive baroreflex sensitivity tests were performed
during both spontaneous and controlled respiration. Fifty-two
consecutive patients with recent myocardial infarction underwent the
analyses. Although the correlations between
phenylephrine and either of the noninvasive methods were
always significant, those found during controlled respiration had the
highest r values (r=.70). However, the
limits of agreement calculated by means of the Bland and Altman method
were wide for both noninvasive methods.
Key Words: myocardial infarction • baroreceptors • phenylephrine
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