Tracking autonomic balance using an open-loop model of the arterial baroreflex

摘要

Blood pressure control is vital for maintaining adequate perfusion of the brain and other organs in the body across varying physiological demands, and the arterial barore-ceptor reflex (barorellex) is the major short-term blood pressure control loop mediated by the autonomic nervous system (ANS). Accurate quantitative models of the baroreflex would provide physiological insight and could allow for real-time tracking of ANS activity in clinical settings. In this work, we formulate a causal, parametric beat-to-beat model, relating systolic blood pressure (input) to heart rate (output). Model structure and parameterization are explicitly based on prior physiological insights of the response dynamics of the sympathetic and parasympathetic branches of the ANS. We analyze the model's ability to track changes in autonomic balance using data from 14 nonsmoking adult males, without any history of cardiopul-monary disease, subject to both pharmacological blockade and postural changes. Our results show that the model parameters faithfully track expected changes in autonomic balance resulting from changing posture (P < 0.01) and sympathetic blockade (P < 0.05), and in many cases, the model parameters are more sensitive to changes in autonomic activity and balance than autonomic indices derived from the power spectral density of heart rate variability. Overall, the contributions of this work further the goal of obtaining real-time quantitative assessment of the ANS.