Non-invasive baroreflex sensitivity measurement was highly correlated with invasive measurement (r=0.91) and provided equivalent prognostic information for survival (RR 0.81, P=0.006).
Observational (n=454)
Does non-invasive measurement of baroreflex sensitivity provide equivalent prognostic information compared to invasive measurement in post-myocardial infarction patients?
Non-invasive measurement of baroreflex sensitivity provides equivalent prognostic information to traditional invasive methods for risk stratification in post-myocardial infarction patients.
Relative Risk: 0.81
p-value: p=0.006
AIMS: The ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) study has proved the independent prognostic value of baroreflex sensitivity. A limitation of the traditional method of estimating baroreflex sensitivity by phenylephrine, is the need to monitor intra-arterial blood pressure. Our objective was to establish whether this invasive method of monitoring could be superseded by non-invasive methods, such as the Finapres device. METHODS AND RESULTS: Patients with three repeated invasive and non-invasive baroreflex sensitivity measurements were selected from the ATRAMI database (n = 454). The mean of these measurements was taken as the baroreflex sensitivity estimate. The repeatability of both methods (standard deviation of the three measurements) decreased with increasing baroreflex sensitivity. There was no constant bias between invasive and non-invasive measurements (0. 22+/-2.2 ms. mmHg(-1), P = 0.42). The linear correlation was very high (r = 0.91, P < 0.01). The normalized 95% limits of agreement were -0.5 and 0.52. On survival analysis, invasive and non-invasive baroreflex sensitivity gave similar prognostic information (likelihood ratio: 155.6 (P = 0.007) and 155.0 (P = 0.006); risk ratio: 0.79 and 0.81, respectively). According to the ATRAMI cut-off points, 85% of patients were classified concordantly by the two methods. None of the patients at high (low) risk with the invasive method were classified as low (high) risk class by the non-invasive method. CONCLUSION: Despite wide limits of agreement, invasive and non-invasive baroreflex sensitivity measurements are highly correlated and provide equivalent prognostic information.
Gian Domenico Pinna (Fri,) conducted a observational in Myocardial infarction (n=454). Non-invasive measurement of baroreflex sensitivity (Finapres) vs. Invasive measurement of baroreflex sensitivity (phenylephrine) was evaluated on Prognostic information on survival analysis (RR 0.81, p=0.006). Non-invasive baroreflex sensitivity measurement was highly correlated with invasive measurement (r=0.91) and provided equivalent prognostic information for survival (RR 0.81, P=0.006).