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Spontaneous baroreflex sensitivity estimates during graded bicycle exercise: a comparative study

In the literature, several methods have been proposed for the assessment of the baroreflex sensitivity from spontaneous variability of heart period and systolic arterial pressure. The present study compares the most utilized approaches for the evaluation of the spontaneous baroreflex sensitivity (i.e. sequence-based, spectral, cross-spectral and model-based techniques) over a protocol capable of inducing a progressive decrease of the baroreflex sensitivity in the presence of a relevant respiratory drive (i.e. a stepwise dynamic bicycle exercise at 10%, 20% and 30% of the maximum nominal individual effort) in 16 healthy humans. Results demonstrated that the degree of correlation among the estimates is related to the structure of the model explicitly or implicitly assumed by the method and depends on the experimental condition (i.e. on the physiological mechanisms contemporaneously active with baroreflex, e.g. cardiopulmonary reflexes). However, even in the presence of a significant correlation, proportional and/or constant biases can be present, thus rendering spontaneous baroreflex estimates not interchangeable. We suggest that the comparison among different baroreflex sensitivity estimates might elucidate physiological mechanisms responsible for the relationship between heart period and systolic arterial pressure.