Estimation of baroreflex sensitivity using transfer function analysis: normal values and theoretical considerations.

Abstract

Human baroreflex sensitivity is traditionally derived from changes in heart rate due to alterations of the baroreceptor input (pharmacologically or physically induced blood pressure changes). Transfer function analysis (TFA) of changes in heart rate (output function) and physiological blood pressure oscillations (input function) at approximately 0.1 Hz (Mayer waves) has already been accepted as a measure of baroreflex sensitivity (BRS). Transfer function analysis provides gain and phase shift values for each frequency band and body position. We performed TFA in 50 normal subjects in the supine and tilted positions, at mid-frequency (0.05-0.15 Hz) and high-frequency (0.15-0.33 Hz) bands, recording heart rate and blood pressure continuously with a Finapres device. Gain values were in accordance with previous studies. Phase shifts lay within a narrow range for all frequency bands and positions. High correlations were found between phase shifts of the same frequency band, but not for those of the same position. This supports the idea that the transfer mechanisms for the two frequency bands may, in part, be different. There was a poor correlation between gain and phase values on the one hand and, on the other hand, further spectral measures and the results of standard autonomic tests. This suggests that TFA may not only be a measure of BRS, but also a complementary tool for evaluation of autonomic function.