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Biomedical subjects

P Castiglioni

Publications and source records attributed to P Castiglioni.

At least 37 records · Page 2Linked to original sources
PubMed1998

Estimation of blood pressure variability from 24-hour ambulatory finger blood pressure.

Portapres is a noninvasive, beat-to-beat finger blood pressure (BP) monitor that has been shown to accurately estimate 24-hour intra-arterial BP at normal and high BPs. However, no information is available on the ability of this device to accurately track ambulatory BP variability. In 20 ambulatory normotensive and hypertensive subjects, we measured 24-hour BP by Portapres and through a brachial artery catheter. BP and pulse interval variabilities were quantified by (1) the SDs of the mean values (overall variability) and (2) spectral power, computed either by fast Fourier transform and autoregressive modeling of segments of 120-second duration for spectral components from 0.025 to 0.50 Hz or in a very low frequency range (between 0.00003 and 0.01 Hz) by broadband spectral analysis. The 24-hour SD of systolic BP obtained from Portapres (24+/-2 mm Hg) was greater than that obtained intra-arterially (17+/-1 mm Hg, P<0.01), but the overestimation was less evident for diastolic (3+/-1 mm Hg, P<0.01) and mean (3+/-1 mm Hg, P<0.01) BP. The BP spectral power <0.15 Hz was also overestimated by Portapres more for systolic than for diastolic and mean BPs; similar findings were obtained by the fast Fourier transform, the autoregressive approach, and focusing on the broadband spectral analysis. BP spectral power >0.15 Hz obtained by the Portapres was similar during the day but lower during the night when compared with those obtained by intra-arterial recordings (P<0.01). No differences were observed between Portapres and intra-arterial recordings for any estimation of pulse interval variabilities. The overestimation of BP variability by Portapres remained constant over virtually the entire 24-hour recording period. Thus, although clinical studies are still needed to demonstrate the clinical relevance of finger BP variability, our study shows that Portapres can be used with little error to estimate 24-hour BP variabilities if diastolic and mean BPs are used. For systolic BP, the greater error can be minimized by using correction factors.

Adult↗
PubMed1997

Time and frequency domain estimates of spontaneous baroreflex sensitivity provide early detection of autonomic dysfunction in diabetes mellitus.

Diabetic autonomic dysfunction is associated with a high risk of mortality which makes its early identification clinically important. The aim of our study was to compare the detection of autonomic dysfunction provided by classical laboratory autonomic function tests with that obtained through computer assessment of the spontaneous sensitivity of the baroreceptor-heart rate reflex (BRS) by time domain and frequency domain techniques. In 20 normotensive diabetic patients (mean age +/- SD 41.9 +/- 8.1 years) with no evidence of autonomic dysfunction on laboratory autonomic testing (D0) blood pressure (BP) and ECG were continuously monitored over 15 min in the supine position. BRS was assessed as the slope of the regression line between spontaneous increases or reductions in systolic BP and linearly related lengthening or shortening in RR interval over sequences of at least 4 consecutive beats (sequence method), or as the squared ratio between RR interval and systolic BP spectral powers around 0.1 Hz. We compared the results with those of 32 age-matched normotensive diabetic patients with abnormal autonomic function tests (D1) and with those of 24 healthy age-matched control subjects with normal autonomic function tests (C). Compared to C, BRS was markedly less in D1 when assessed by both the slope of the two types of sequences (data pooled) and by the spectral method (-71.3% and -60.2% respectively, both p < 0.01). However, BRS was consistently although somewhat less markedly reduced in D0, the reduction being clearly evident for all the estimates (-57.0% and -43.5%, both p < 0.01). The effects were more evident than those obtained by the simple quantification of the RR interval variability. These data suggest that time and frequency domain estimates of spontaneous BRS allow earlier detection of diabetic autonomic dysfunction than classical laboratory autonomic tests. The estimates can be obtained by short non-invasive recording of the BP and RR interval signals in the supine patient, i.e. under conditions suitable for routine outpatient evaluation.

Adult↗
PubMed1997

Dynamic detection of rhythmic oscillations in heart-rate tracings: a state-space approach based on fourth-order cumulants.

This paper presents a new procedure specifically aimed at providing a dynamical detection of the oscillations occurring in long-term heart-rate (HR) tracings. The procedure is based on a time-variant state-space modelling of the fourth-order cumulants of the HR signal. The state-space estimator was selected because of its demonstrated capability to distinguish between deterministic and stochastic components of the signal, while the fourth-order cumulants of the signal were used as input of the model to further reduce adverse effects of coloured, white and l/f Gaussian noise possibly present in the input data. The procedure was tested by the analysis of simulated signals and its performance was compared with the results obtained by state-space modelling applied directly on the test signals (instead of on the fourth-order cumulants of the signals) and by the more traditional auto-regressive modelling. The comparison has shown a clear superiority of the proposed procedure over the other techniques in discriminating deterministic oscillations from coloured noise. Finally, the applicability of the procedure to biological data was verified by analysing five experimental HR tracings recorded in normal subjects during laboratory and daily life conditions.

Electrocardiography↗
PubMed1997

Dap (Defective aleurone pigmentation) mutations affect maize aleurone development.

Dap (Defective aleurone pigmentation) is the designation for mutations in maize that give rise to a characteristic dappled endosperm phenotype, consisting of patches of purple tissue, of variable size and shape, on a yellow background. Features shared by all Dap mutants are: dominant expression when they are maternally derived, lack of expression or transmission when they originate from pollen, failure to recover homozygous Dap genotypes, reduced frequency of Dap seeds in the progeny of outcrosses of Dap/+ females, association of the dappled phenotype with reduction in seed size. The mutants so far tested, six in all, can be grouped into two classes, one including male-transmissible (MT) isolates not expressed in the endosperm if their contribution is paternal, and a second class of isolates (NMT) that are permanently lost following paternal transmission. We suggest that the NMT mutations are on a chromosome that carries an intercalary deletion. Assuming linkage between the mutant and the deletion, selection against the deficient chromosome during male gametogenesis would account for the failure to recover Dap seeds in the progeny of Dap/+ male parents. We have obtained genetic evidence supporting this hypothesis. This interpretation, however, does not apply to MT alleles. For these, other mechanisms, such as imprinting and/or dosage effects may be proposed. The mutable pattern in the endosperm to which all Dap mutants give rise is an intriguing phenotype which remains to be clarified. An unexpected finding is that aleuronic and subaleuronic cells corresponding to the colourless areas are abnormal in shape and anthocyanin biosynthesis is blocked in these cells. This finding calls for further investigation in light of a possible connection between flavonoid precursors and cell shape.

Anthocyanins↗
PubMed1997

Autonomic cardiac regulation in obstructive sleep apnea syndrome: evidence from spontaneous baroreflex analysis during sleep.

OBJECTIVE: To assess spontaneous baroreceptor-heart rate reflex sensitivity during sleep in patients with obstructive sleep apnea syndrome, a condition associated with increased cardiovascular morbidity and mortality and characterized by marked sympathetic activation, which is believed to originate from hypoxic chemoreceptor stimulation, although little is known of other possible mechanisms such as baroreflex impairment. DESIGN AND METHODS: In 11 patients with severe obstructive sleep apnea syndrome (mean+/-SD age 46.8+/-8.1 years, apnea/hypopnea index 67.9+/-19.1 h), who were normotensive or borderline hypertensive during wakefulness by clinic blood pressure measurements, finger blood pressure was monitored beat-by-beat non-invasively (Finapres) at night during polysomnography. Periods of wakefulness and sleep were identified based on electroencephalographic recordings. Baroreflex sensitivity was assessed by the sequence technique, as the slope of the regression line between spontaneous increases or reductions in systolic blood pressure (SBP) and the related lengthening or shortening in the RR interval, occurring over spontaneous sequences of four or more consecutive beats. The number of these sequences was also computed, as an additional index of baroreflex engagement by the spontaneous blood pressure fluctuations. The controls were age-related normotensive or borderline hypertensive subjects without sleep apnea who had been investigated in previous studies; in these subjects blood pressure was recorded intra-arterially over 24 h in ambulatory conditions and spontaneous baroreflex sensitivity was assessed by the sequence technique. RESULTS: In our patients the lowest nocturnal arterial oxygen saturation was 78.6+/-12.1% (mean+/-SD). During sleep, the number of pooled +RR/+SBP and -RR/-SBP sequences per hour was 20.3+/-2.7 per h in patients with sleep apnea and 27.1+/-2.1 /h in controls (means+/-SEM). The average baroreflex sensitivity during sleep periods was 7.04+/-0.8 ms/mmHg in sleep apnea patients and 10.05+/-2.1 ms/mmHg in controls. Both the pooled number of sequences and baroreflex sensitivity values of the sleep apnea patients were significantly (P < 0.01) less than the corresponding night values of control subjects. In the sleep apnea patients, at variance from controls, baroreflex sensitivity did not show any increase during sleep compared with its values during wakefulness (6.9+/-1.0 ms/mmHg). CONCLUSIONS: Our data provide evidence that spontaneous baroceptor reflex sensitivity is depressed in severe obstructive sleep apnea syndrome. This suggests that in such patients baroreflex dysfunction and not only chemoreceptor stimulation by hypoxia may be involved in the sympathetic activation which occurs during sleep. Such dysfunction may contribute to the higher rate of cardiovascular morbidity and mortality reported in these patients.

Adult↗
PubMed1997

Smoking impairs baroreflex sensitivity in humans.

In 10 healthy smokers, finger blood pressure was recorded continuously for 1 h in a supine control condition and for 1 h while smoking four cigarettes, one every 15 min. Smoking increased average systolic blood pressure (+19%, P < 0.01) and its variability and reduced pulse interval (reciprocal of heart rate, -22%, P < 0.01) and its variability. Baroreflex sensitivity, as assessed by the slope of spontaneous hypertension/bradycardia or hypotension/tachycardia sequences and by the alpha-coefficient (squared ratio between pulse interval and systolic blood pressure spectral powers at 0.1 Hz) was significantly decreased (P < 0.01) during smoking, whereas there were no effects of smoking on the reflex changes in pulse interval induced by carotid baroreceptor stimulation through a neck suction device. Sham smoking by a drinking straw had no effects on any of the above parameters. Thus, when assessed in the absence of laboratory maneuvers in daily life conditions, baroreflex sensitivity is markedly impaired by smoking. This impairment may contribute to the smoking-induced increase in blood pressure and heart rate as well as to the concomitant alterations in their variability.

Adult↗
PubMed1997

Modulation of pulmonary arterial input impedance during transition from inspiration to expiration.

We investigated whether respiration influences pulmonary arterial input impedance during transition from inspiration to expiration in five anesthetized, spontaneously breathing dogs. Impedance (Z) was separately assessed for heart beats occurring in inspiration, in expiration, and during the transition from inspiration to expiration (transitional beat). Transitional beats were scored by the ratio between the fraction of beat falling in expiration and the total beat duration [expiratory fraction (Efr)] to quantify their position within the transition. In transitional beats, input resistance linearly increased with Efr; Z modulus at the heart-rate frequency (fHR) decreased up to -50% for Efr = 50%. Z phase at fHR was greater than in inspiration for Efr <40% and lower for Efr >50%. Unlike blood flow velocity, mean value and first harmonic of pulmonary arterial pressure were correlated to Efr and paralleled the changes of input resistance and Z at fHR. This indicates that respiration influences Z through modifications in arterial pressure. The evidence of important respiratory influences on Z function may help the pathophysiological interpretation of dysfunctions of the right heart pumping action, such as the so-called cor pulmonale.

Animals↗
PubMed1997

Broadband spectral analysis of blood pressure and heart rate variability in very elderly subjects.

Systolic blood pressure (SBP) variability is increased and R-R interval variability is reduced in the elderly. Little is known, however, about how SBP and R-R interval variabilities change in the very elderly. More important, however, it is not known which frequency components of SBP and R-R interval variability are affected significantly. We addressed this issue in subjects older than 70 years by broadband spectral analysis, which allows all variability components from the lowest to the highest frequency to be considered. In 20 very elderly normotensive subjects (mean +/- SD age, 78.1 +/- 6.8 years) and 28 normotensive adult subjects (36.1 +/- 7.1 years), noninvasive finger blood pressure and R-R intervals were recorded continuously for 30 minutes in the supine position and 15 minutes in the upright position. SBP and R-R interval power spectral densities were computed over the entire frequency region between 0.005 Hz (0.007 Hz in the upright position) and 0.5 Hz. Overall SBP variability (SD) was greater and overall R-R interval variability was less in very old subjects than in adult subjects. All spectral R-R interval powers were reduced significantly in very elderly individuals. The spectral SBP powers were greater in the very elderly group than in the adult group only in the very-low-frequency range (<0.04 Hz). This was true in the supine and the standing positions. With subjects in the standing position, the shape of the broadband spectra differed in the very old and adult subjects because in the former group the increase in SBP and R-R interval power around 0.1 Hz that was seen in the latter was blunted. Therefore, in very elderly subjects a reduction in overall R-R interval variability is accounted for by a reduction in all of its frequency components. The accompanying increase in overall BP variability, however, results from a nonhomogeneous behavior of its frequency components, which consists of an increase in the very low frequency and a concomitant reduction in the higher frequency powers. The mechanisms responsible for these changes may be complex, but at least they may in part reflect the baroreflex impairment and autonomic dysfunction that characterize aging.

Adult↗
PubMed1997

Critical appraisal of indices for the assessment of baroreflex sensitivity.

The sequence technique and the spectral estimation of the alpha coefficient are currently employed for the assessment of "spontaneous" baroreflex sensitivity (BRS). The comparison of performance and effectiveness of these techniques is obtained by the analysis of systolic blood pressure (SBP) and pulse interval (PI) tracings recorded in conscious cats before and after baroreceptor denervation. Results indicate that (1) the average BRS estimates obtained by the sequence technique and by the alpha coefficient at the respiratory frequency are similar, (2) the alpha coefficients computed at the respiratory frequency tend to be higher than alpha coefficients estimated at 0.1 Hz, and (3) in spite of what is traditionally claimed, the PI-SBP coherence does not seem to represent a reliable parameter to enhance the specificity of the spectral estimate, because coherence values often remain above the 0.5 threshold also after baroreceptor denervation.

Animals↗
PubMed1996

Effects of sino-aortic denervation on spectral characteristics of blood pressure and pulse interval variability: a wide-band approach.

Sino-aortic denervation (SAD) is employed in cats to evaluate the baroreflex influence on blood pressure (BP) and pulse interval (PI) spectral components from 0.00008 to 0.9 Hz as assessed by FFT wide-band spectra and their 1/f modelling; and the linear coupling between BP and PI and between systolic and diastolic BP as assessed by coherence analysis. Specific procedures have been developed to obtain an effective smoothing of spectra and coherence functions. SAD induced an increase in BP powers from 0.03 to 0.0006 Hz and a power reduction of most of the remaining BP components; a reduction of PI powers at all frequencies; marked deviations of BP spectra from the 1/f trend; a reduction of the coherence between BP and PI from 0.12 to 0.5 Hz and a coherence enhancement at lower frequencies. These findings indicate that the arterial baroreflex modulates both fast and slow spectral components of BP and PI; homogeneously enhances PI fluctuations at all frequencies; produces differentiated effects on BP fluctuations along the frequency axis; and at low frequencies exerts the buffering action on BP through strategies which reduce the BP-PI linear link.

Animals↗
PubMed1996

Does spontaneous respiration alter pulmonary artery input impedance?

The aim of this study was to determine whether spontaneous respiration influences pulmonary artery input impedance, a question that has received little attention in the literature. Impedance values were assessed during three different phases of the respiratory cycle, namely inspiration, expiration and postexpiration (i.e. the null respiratory flow period between expiration and the next inspiration) in five anaesthetized spontaneously breathing dogs. Firstly, impedance values during postexpiration were taken as the reference baseline, and compared with values obtained during inspiration and expiration. Then, differences between values in inspiration and in expiration were tested, taking impedance during inspiration as the baseline. Differences with respect to postexpiration were found for three parameters of input impedance: input resistance, characteristic impedance, and the frequency at the first zero-crossing of the impedance phase from negative to positive values (f(cross)). Input resistance was significantly lower in inspiration (85% of the baseline), characteristic impedance was significantly greater in inspiration and in expiration (112 and 119% respectively), and f(cross) was significantly lower in expiration (89%). By contrast, only input resistance differed significantly when inspiration was compared to expiration. Therefore, spontaneous respiration was shown to influence input impedance significantly. The observed changes in characteristic impedance and f(cross) might be explained by a stiffening of the pulmonary artery wall, due to neural and/or mechanical factors, during inspiration and expiration.

Animals↗
PubMed1996

Baroreflex modulation of the cardiovascular system: new insights from the joint analysis of blood pressure and heart rate signals.

This paper focuses on a number of methods for the analysis of the relationship between the arterial baroreflex and different components of blood pressure and heart rate variability. Broad-band spectral analysis techniques have allowed us to obtain experimental evidence that the arterial baroreflex exerts its influence not only on fast but also on slow components of blood pressure and heart rate, i.e., on components with periods longer than 60 sec. Focusing on faster changes in blood pressure and heart rate, both time domain and frequency domain techniques have been developed to track the sensitivity of baroreflex heart rate modulation over time, either in laboratory or in daily life conditions. These approaches have considerably broadened our understanding of the role of baroreflex modulation of the heart and peripheral circulation in a number of pathological and physiological conditions.

Animals↗
PubMed1995

Effects of aging on 24-h dynamic baroreceptor control of heart rate in ambulant subjects.

The effects of aging on the dynamic modulation of baroreflex sensitivity over 24 h was assessed in eight elderly (mean age +/- SD, 63.9 +/- 3.2 yr) and in eight young (23.9 +/- 6.1 yr) mild or moderate essential hypertensive patients, who were subject to a 24-h intra-arterial (Oxford technique) blood pressure recording in ambulatory conditions. The sensitivity of baroreflex control of the heart rate was dynamically assessed by quantifying 1) the slope of the regression line between pulse interval (the reciprocal of heart rate) and systolic blood pressure changes over spontaneously occurring hypertension-bradycardia or hypotension-tachycardia sequences (time domain analysis) and 2) the ratio between spectral-powers of pulse interval and systolic blood pressure around 0.1 Hz (alpha-coefficient: frequency domain analysis). The 24-h average sequence slope was lower in old than in young individuals (4.4 +/- 0.5 vs. 9.9 +/- 1.3 and 4.8 +/- 0.7 vs. 8.4 +/- 1.4 ms/mmHg for hypertension-bradycardia and hypotension-tachycardia sequences, respectively; P < 0.05 for both). Similar results were obtained by using the alpha-coefficient approach. The marked nighttime increase in baroreflex sensitivity observed in young individuals was much less evident in the elderly. Thus 24-h baroreflex sensitivity is markedly impaired by aging. The impairment becomes manifest also as an inability to increase baroreflex sensitivity at night.

Aged↗
PubMed1995

Sympathectomy and cardiovascular spectral components in conscious normotensive rats.

We examined the extent to which sympathetic influences are reflected by spectral powers of blood pressure and pulse interval in specific frequency bands in spontaneously behaving Wistar-Kyoto rats subjected to continuous intraarterial blood pressure recording. The rats were pretreated with 6-hydroxydopamine (150 mg/kg twice in 1 week, n = 19) to produce chemical sympathectomy or received vehicle (n = 15). In the sympathectomized group, additional monitoring sessions were performed with rats under alpha-adrenergic receptor blockade with phenoxybenzamine (n = 8), beta-receptor blockade with propranolol (n = 7), or cholinergic receptor blockade with atropine (n = 8). Blood pressure signals were analyzed by a computer to calculate spectral powers (fast Fourier transform) in the low-frequency (0.025 to 0.1 Hz), mid-frequency (0.1 to 0.6 Hz), and high-frequency (0.8 to 3.0 Hz) bands. In sympathectomized rats, low-frequency power of blood pressure was 70% greater than in intact rats, whereas mid-frequency power was 60% smaller (P < .05 for both) and high-frequency power was unchanged. High-frequency power of pulse interval was also unchanged in sympathectomized rats, whereas low- and mid-frequency powers were reduced by approximately 50% (P < .05). No further alterations in spectral powers were observed by adding alpha- or beta-adrenergic blockade to sympathectomy, whereas adding cholinergic blockade caused a striking reduction in all pulse interval powers. Thus, mid-frequency blood pressure power depends on sympathetic but also to a substantial extent on nonsympathetic influences. Sympathetic influences do not contribute to low-frequency blood pressure power, having instead a restraining effect. The low- and mid-frequency pulse interval powers depend on both sympathetic and vagal influences. Thus, no blood pressure or pulse interval power in the mid- and low-frequency ranges can be regarded as a specific marker of sympathetic activity.

Adrenergic alpha-Antagonists↗
PubMed1995

Sympathetic, parasympathetic and non-autonomic contributions to cardiovascular spectral powers in unanesthetized spontaneously hypertensive rats.

OBJECTIVE: To determine whether spectral powers of blood pressure and pulse interval can specifically reflect sympathetic and parasympathetic effects in unanesthetized, free-moving spontaneously hypertensive rats (SHR). DESIGN: Spectral powers were observed before and after various autonomic interventions in chronically instrumented rats. MATERIALS AND METHODS: Chemical sympathectomy was produced in 12-week-old SHR by repeated injections of 6-hydroxydopamine, while control rats were given vehicle alone. Chronic arterial and venous catheters were inserted in the femoral artery and vein. Blood pressure was recorded beat-to-beat for 90 min in free-moving rats; further recording sessions were obtained under additional alpha-receptor blockade with phenoxybenzamine at 1 mg/kg and/or additional cholinergic blockade with atropine at 0.8 mg/kg. Off-line computer analysis (fast Fourier transform) provided estimates of low- (0.025-0.1 Hz), mid- (0.1-0.6 Hz) and high-frequency (0.8-3.0 Hz) powers for blood pressure and pulse interval over consecutive periods of 100 s. RESULTS: The most noticeable findings were that sympathectomy produced a striking increase in the low-frequency power of blood pressure and a tendency (borderline statistical significance) to reduce the mid-frequency power of blood pressure. Additional alpha-receptor blockade had no effect on any spectral power whereas additional cholinergic blockade caused a further increase in the low-frequency blood pressure power and a drastic reduction in all pulse interval powers. CONCLUSIONS: In the unanesthetized SHR, sympathetic activity opposes low-frequency and marginally promotes mid-frequency blood pressure fluctuations; the pulse interval spectral expression of vagal effects is spread throughout the range of frequencies explored and is not confined to the high-frequency band. These data indicate that in SHR no spectral power can specifically reflect the effects of either autonomic limb.

Adrenergic Fibers↗