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J Appl Physiol 102: 1724, 2007; doi:10.1152/japplphysiol.00087.2007
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LETTER TO THE EDITOR

Reply to Dr. Cysarz's comment on Point:Counterpoint "Cardiovascular variability is/is not an index of autonomic control of circulation"

TO THE EDITOR: In the frame of the Point:Counterpoint debate on cardiovascular variability analysis (5), the utility of non-linear tools has been highlighted (1). Actually, complexity-based and non-linear techniques allow aspects of cardiovascular dynamics hardly quantified by traditional approaches to be described, as recently shown (4). Notwithstanding research on these methods started long ago (3), complex mathematical formalisms and lack of standardization limited the diffusion of these techniques and thus full understanding of their clinical relevance. In this context, Dr. Cysarz mentions the potential utility of symbolic analysis to investigate accelerations and deceleration of instantaneous heart rate. This analysis is somewhat related to analysis of patterns, another non-linear approach that shares with symbolic analysis the advantage of providing simple and straightforward physiological interpretations. In this respect, we recall that a consolidated technique based on a joint pattern analysis of blood pressure and heart rate variability is the sequence technique (2) used to assess the features of baroreflex control of the heart. In this case, pattern analysis identifies runs of consecutive beats in which systolic blood pressure and R-R interval progressively and concomitantly increase or decrease. Information on baroreflex sensitivity and baroreflex effectiveness (2) are routinely derived from subsequent analyses of these patterns.

FOOTNOTES


Address for reprint requests and other correspondence: M. Di Rienzo, Centro di Bioingegneria, via Capecelatro 66, Milan, Italy 20148 (e-mail: mdirienzo{at}cbi.dongnocchi.it)

REFERENCES

  1. Cysarz D. Comment on Point:Counterpoint "Cardiovascular variability is/is not an index of autonomic control of circulation". J Appl Physiol. In press.
  2. Di Rienzo M, Parati G, Castiglioni P, Tordi R, Mancia G, Pedotti A. Baroreflex effectiveness index: an additional measure of baroreflex control of heart rate in daily life. Am J Physiol Regul Integr Comp Physiol 280: R744–R751, 2001.[Abstract/Free Full Text]
  3. Goldberger AL. Non-linear dynamics for clinicians: chaos theory, fractals, and complexity at the bedside. Lancet 347: 1312–1314, 1996.[CrossRef][Web of Science][Medline]
  4. Merati G, Di Rienzo M, Parati G, Veicsteinas A, Castiglioni P. Assessment of the autonomic control of heart rate variability in healthy and spinal-cord injured subjects: contribution of different complexity-based estimators. IEEE Trans Biomed Eng 53: 43–52, 2006.[CrossRef][Web of Science][Medline]
  5. Parati G, Di Rienzo M, Castiglioni P, Mancia G, Taylor Studinger P JA. Point:Counterpoint: Cardiovascular variability is/is not an index of autonomic control of circulation. J Appl Physiol 101: 676–682, 2006.[Abstract/Free Full Text]

M. Di Rienzo1
P. Castiglioni1
G. Parati2
 1Centro di Bioingegneria, Fondazione Don Carlo Gnocchi; 2Universite Milano Bicocca and Istituto Auxologico Italiano, Milan, Italy





This Article
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Right arrow Articles by Di Rienzo, M.
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