Arterial baroreflex sensitivity: Relationship with peripheral chemoreflex in patients with chronic heart failure

Abstract

Background: The purpose of this study was to evaluate the relationship between the breath-holding duration and the sensitivity of the arterial baroreflex, as well as the prognostic value of the breath-holding test in the assessment of decreased baroreflex sensitivity (BRS) in patients with chronic heart failure (CHF). Methods: The study was conducted on 87 patients with CHF. In all participants, the breath-holding test was performed in the morning, while the single-breath carbon dioxide test was performed on the next day; the injection method was used to evaluate BRS. Other parameters, including pulse wave velocity (PWV), N-terminal pro-brain natriuretic peptide (NT-proBNP) level, and spirometry and echocardiography findings, were also evaluated. Results: A significant correlation was found between BRS and the following two parameters: breath-holding duration and left ventricular ejection fraction (all p < 0.05) and a significant negative correlation between BRS and the following three parameters: age, NT-proBNP level, and PWV (all p < 0.05). After analysis, only the breath-holding duration remained significant in our model (R2 adjusted for the model, 0.55). The breath-holding duration was a good predictor of decreased BRS (<3 ms/mmHg), with a cut-off point of <34 s [area under curve, 0.876 (0.778–0.937, p < 0.0001)]. Conclusion: A reduced breath-holding duration is associated with decreased sensitivity of the arterial baroreflex. If the duration of the breath-holding test is <34 s, decreased BRS is predicted. This test can be effectively used for the initial assessment of the level of the reflex regulation of the cardiorespiratory system in patients with CHF.

Keywords

• Arterial baroreflex
• Peripheral chemoreflex
• Heart failure