Estimation of baroreflex sensitivity by the bivariate phase rectified signal averaging method: a comparison with the phenylephrine method
Key result
PRSA-BRS correlates moderately with the phenylephrine test but shows marked disagreement in absolute measurements.
- r = 0.53
- P<0.0001
- n=233
Why the study?
Does PRSA-BRS accurately estimate baroreflex sensitivity compared to the phenylephrine method in HF and post-MI patients?
Population
233 patients, comprising 192 with heart failure (HF) and 41 post-myocardial infarction (post-MI)
Comparison
Bivariate phase-rectified signal averaging for… vs Phenylephrine test (Phe-BRS)
Design
Cross-sectional
Authors
Discussion
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Implication
PRSA-BRS should not replace phenylephrine testing in HF or post-MI; leaves open its role as a noninvasive research surrogate.
Study Design
Type
Observational (n=233)
Structured PICO
Does PRSA-BRS accurately estimate baroreflex sensitivity compared to the phenylephrine method in HF and post-MI patients?
P
Population
233 patients (192 with heart failure and 41 post-myocardial infarction) evaluated for baroreflex sensitivity using PRSA-BRS and Phe-BRS.
E
Exposure
Bivariate phase-rectified signal averaging (PRSA-BRS) for estimating baroreflex sensitivity
C
Comparator
Phenylephrine test (Phe-BRS)
O
Outcome
Association and agreement between PRSA-BRS and Phe-BRSsurrogate
Main Result
Effect estimate: r = 0.53
p-value: p=<0.0001
Despite a moderate correlation, PRSA-BRS shows marked disagreement with the reference phenylephrine method and cannot be used as a direct estimate of baroreflex sensitivity.
Limitations
- Different physiological conditions under which Phe-BRS and PRSA-BRS are measured
- Inclusion of non-baroreflex mediated components of RR-intervals in PRSA-BRS
- Computational aspects related to the normalization of PRSA-BRS values
Cite This Study
Maestri et al. (2017) conducted an observational in Heart failure and post-myocardial infarction (n=233). Bivariate phase-rectified signal averaging (PRSA-BRS) vs. Phenylephrine test (Phe-BRS) was evaluated on Association and agreement between PRSA-BRS and Phe-BRS (r = 0.53, p=<0.0001). Bivariate phase-rectified signal averaging (PRSA-BRS) showed moderate correlation with the phenylephrine test (r=0.53 in HF, P<0.0001) but marked disagreement in absolute measurements.