A Novel Assessment of Baroreflex Activity Through the Similarity of Ternary Codes of Oscillations Between Arterial Blood
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ORIGINAL ARTICLE
A Novel Assessment of Baroreflex Activity Through the Similarity of Ternary Codes of Oscillations Between Arterial Blood Pressure and R–R Intervals Po‑Wei Chen1 · Chun‑Keng Lin2 · Wei‑Min Liu3 · Yu‑Chen Chen4,5 · Sheng‑Tzung Tsai4,5 · An‑Bang Liu6 Received: 12 March 2020 / Accepted: 16 July 2020 © Taiwanese Society of Biomedical Engineering 2020
Abstract Purpose Arterial baroreflex plays a crucial role in the homeostasis of blood pressure. Elevated blood pressure stimulates baroreceptors and slows the heart rate consequently. Baroreflex activity has been quantified as the relationship between systolic blood pressure (SBP) and ECG R–R intervals (RRI), which is called baroreflex sensitivity (BRS). The purpose of this study is to define a new parameter of BRS and verify the reproducibility and validity of this indicator as compared with a popular BRS estimated by sequence method and a traditional BRS evaluated by pharmacological intervention. Methods At first, the spontaneous oscillations of SBP and RRI were defined by ternary arithmetic codes: decrease as 0, unchanged as 1 and increase as 2. The new BRS was quantified as the similarity between these two ternary coded series after decimalization with different digits from 3 to 5. The validity and reproducibility of this method were verified in vivo in 10 adult male Wistar Kyoto rats. Results This new parameter correlated well with the BRS estimated by the sequence method and pharmacological interven‑ tion. The reproducibility of this novel method was good according to the Bland–Altman plot. Conclusions This study offered a simple and reliable algorithm to estimate BRS, which can be embed in current instruments for clinical research. Keywords Baroreflex sensitivity · R–R intervals · Arithmetic coding · Spontaneous oscillation
1 Introduction * An‑Bang Liu [email protected] 1
Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
2
Department of Electrical Engineering, National Dong Hwa University, Hualien, Taiwan
3
Department of Computer Science and Information Engineering, National Chung Cheng University, Chiayi, Taiwan
4
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
5
Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
6
Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, No. 707, Sec. 3, Chung‑Yang, Rd., Hualien City 970, Hualien, Taiwan
Arterial baroreflex plays a key role in the homeostasis of blood pressure. It provides a negative feedback loop from baroreceptors in the aortic arch and carotid sinuses to the solitary nuclei in the brainstem through the glossopharyn‑ geal and vagus nerves [1]. The elevation of blood pressure stimulates baroreceptors and increases parasympathetic activity, which slows the heart rate, decreases cardiac con‑ tractility, causes vasodilatation, and eventually decreases
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