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

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 (R-2 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. (C) 2018 The Authors. Published by Elsevier B.V. on behalf of Association for Research into Arterial Structure and Physiology.