Abstract
Spectral analysis (SA) of blood pressure (BP) and heart rate (HR) fluctuations has been proposed as a unique approach to obtain a deeper insight into cardiovascular regulatory mechanisms in health and disease. A number of studies performed over the last 15 years have shown that autonomic influences are involved in the modulation of fast BP and HR fluctuations (with a period<1 min), particularly at frequencies between 0.2 and 0.4 Hz [high frequency (HF) region or respiratory frequency] and around 0.1 Hz [mid frequency (MF) region]. In patients with secondary or primary autonomic dysfunction, SA of BP and HR signals recorded at rest or during orthostatic challenge in a laboratory environment have shown the occurrence of a reduction in the power of MF and/or HF, BP and HR components. Such a reduction is associated or may even precede the clinical manifestation of autonomic neuropathy. However, the above results collected in standardized laboratory conditions cannot reflect the features of neural cardiovascular control during daily life in ambulant individuals with autonomic failure. To investigate this issue, SA techniques have been applied to 24 h beat-to-beat intra-arterial and non-invasive finger BP recordings obtained in elderly subjects and in pure autonomic failure patients, respectively. In these conditions, HR powers displayed a reduction over a wide range of frequencies (from 0.5 to below 0.01 Hz). Conversely, BP powers underwent a complex rearrangement characterized by a reduction in the power around 0.1 Hz and by an increase in the powers at the respiratory frequency and at frequencies below 0.01 Hz. Dynamic quantification of the sensitivity of the baroreceptor-heart rate reflex by combined analysis of systolic BP and pulse interval (i.e. the interval between consecutive systolic peaks) powers around 0.1 Hz (alpha technique) has shown that in elderly subjects, and even more so in pure autonomic failure patients, baroreflex sensitivity is markedly reduced over the 24 h, and is no longer characterized by its physiological day-night modulation. In conclusion, although in some instances SA of cardiovascular signals may fail to fully reflect the features of autonomic cardiovascular control, the evidence discussed clearly demonstrates that this approach represents a promising tool for a dynamic assessment of the early impairment of neural circulatory control in autonomic failure. This is particularly the case when these analyses are performed on 24 h continuous BP and HR recordings in ambulant subjects.
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References
Littler WA, West MJ, Honour AJ, Sleight P. The variability of arterial pressure.Am Heart J 1978:95: 180–186.
Floras JS, Sleight P. The lability of blood pressure. In: Amery A, Fagard R, Lijnen P, Staessen J, eds.Hypertensive Cardiovascular Disease: Pathophysiology and Treatment. The Hague: Martinus Nijhoff, 1982; 104–117.
Mancia G, Ferrari A, Gregorini L et al. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings.Circ Res 1983;53: 96–104.
Mancia G, Zanchetti A. Blood pressure variability. In: Zanchetti A, Tarazi RC, eds.Pathophysiology of Hypertension: Cardiovascular Aspects.Handbook of Hypertension, vol. 7. Amsterdam: Elsevier, 1986; 125–152.
Parati G, Mutti E, Omboni S, Mancia G. How to deal with blood pressure variability. In: Brunner H, Waeber B, eds.Ambulatory Blood Pressure Recording. New York: Raven Press, 1991; 71–99.
Hyndman BW, Kitney RI, Sayers BM. Spontaneous rhythms in physiological control systems.Nature 1971;233: 339–341.
Kay SM, Marple SL. Spectrum analysis—a modern perspective.Proc IEEE 1981;69: 1380–1419.
Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control.Science 1981;21: 220–223.
Appel ML, Berger RD, Saul JP, Smith JM, Cohen RJ. Beat to beat variability in cardiovascular variables: noise or music?J Am Coll Cardiol 1989;14: 1139–1148.
Di Rienzo M, Castiglioni P, Ramirez AJ, Mancia G, Pedotti A. Sequential spectral analysis of blood pressure and heart rate in humans and animals. In Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Blood Pressure and Heart Rate Variability. Amsterdam: IOS Press, 1993; 24–38.
Malliani A, Lombardi F, Pagani M. Power spectrum analysis of heart rate variability: a tool to explore neural regulatory mechanisms.Br Heart J 1994;71: 1–2.
Parati G, Saul JP, Di Rienzo M, Mancia G. Spectral analysis of blood pressure and heart rate variability in evaluating cardiovascular regulation: a critical appraisalHypertension 1995;25: 1276–1286.
Spiers JP, Silke B, McDermott U, Shanks RG Harron DWG. Time and frequency domain assessment of heart rate variability: a theoretical and clinical appreciation.Clin Auton Res 1993;3: 145–158.
Kamath MV, Fallen EL. Power spectral analysis of heart rate variability: a noninvasive signature of cardiac autonomic function.Crit Rev Biomed Eng 1993:21: 245–311.
Malik M, Camm AJ. Heart rate variability and clinical cardiology.Br Heart J 1994;71: 3–6.
Malliani A, Pagani M, Lombardi F. Physiology and clinical implications of variability of cardiovascular parameters with focus on heart rate and blood pressure.Am J Cardiol 1994;73: 3C-9C.
Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: a measure of cardiac autonomic tone.Am Heart J 1994;127: 1376–1381.
Pomeranz B, Macaulay RJB, Caudill MA et al. Assessment of autonomic function in humans by heart rate spectral analysis.Am J Physiol 1985;248: H151-H153.
Akselrod S, Gordon D, Madwed JB, Snidman NC, Shannon DC, Cohen RJ. Hemodynamic regulation: investigation by spectral analysis.Am J Physiol 1985;249 (Heart Circ. 18): H867-H875.
Pagani M, Lombardi F, Guzzetti S et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.Circ Res 1986;59: 178–193.
Saul JP, Berger RD, Albrecht P, Stein SP, Chen MH, Cohen RJ. Transfer function analysis of the circulation: unique insights into cardiovascular regulation.Am J Physiol 1991;261: H1231-H1245.
Hales S.Statistical Essays: Containing Haemastaticks. Vol. 2. London, Ihnys, Manby and Woodward, 1733
Koepchen HP. History of studies and concepts of blood pressure waves. In: Miyakawa K, Polosa C, Koepchen HP, eds.Mechanisms of Blood Pressure Waves. Berlin: Springer-Verlag, 1984; 3–23.
de Boer RW, Karemaker JM, Strackee J. Hemodynamic fluctuation and baroreflex sensitivity in humans: a beat-to-beat model.Am J Physiol 1987;253; H680-H689.
Peters J, Fraser C, Stuart RS, Baumgartner W, Robotham JL. Negative intrathoracic pressure decreases independently left ventricular filling and emptying.Am J Physiol 1989;257:H120-H131.
Peters J, Kindred MK, Robotham JL. Transient analysis of cardiopulmonary interactions. I. Diastolic events.J Appl Physiol 1988;64: 1506–1517.
Peters J, Kindred MK, Robotham JL., Transient analysis of cardiopulmonary interactions. II. Systolic events.J Appl Physiol 1988;64: 1518–1526.
Katona PG, Jih F. Respiratory sinus arrhythmia: noninvasive measure of parasympathetic cardiac control.J Appl Physiol 1975;39: 801–805.
Eckberg DL. Human sinus arrhythmia as an index of vagal cardiac outflow.J Appl Physiol 1983;54: 961–966.
Goldberger JJ, Ahmed MW, Parker MA, Kadish AH. Dissociation of heart rate variability from parasympathetic tone.Am J Physiol 1994;266: H2152-H2157.
Fouad FM, Tarazi RC, Ferrario CM, Fighaly S, Alicandri C, Assessment of parasympathetic control of heart rate by a non-invasive method.Am J Physiol 1984;246: H838-H842.
Bernardi L, Keller F, Sanders M et al. Respiratory sinus arrhythmia in the denervated human heart.J Appl Physiol 1989;67: 1447–1455.
Peñáz J. Mayer waves: history and methodology.Automedica 1978;2: 135–141.
Bernardi L, Leuzzi S, Radaelli A, Passino C, Johnston JA, Sleigh P. Low frequency spontaneous fluctuations of R-R interval and blood pressure in conscious humans: a baroreceptor or central phenomenon?Clin Sci 1994;87: 649–654.
Furlan R, Guzzetti S, Crivellaro W et al. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects.Circulation 1990;81: 537–547.
Parati G, Castiglioni P, Di Rienzo M, Omboni S, Pedotti A, Mancia G. Sequential spectral analysis of 24-hour blood pressure and pulse interval in humans.Hypertension 1990:16: 414–421.
Berger RD, Saul JP, Cohen RJ. Transfer function analysis of autonomic regulation. I. Canine atrial rate response.Am J Physiol 1989;256: H142-H152.
Saul JP, Berger RD, Chen MH, Cohen RJ. Transfer function analysis of autonomic regulation. II. Respiratory sinus arrhythmia.Am J Physiol 1989;256: H153-H161.
Burton AC. The range and variability of the blood flow in the human finger and the vasomotor regulation of body temperature.Am J Physiol 1939;127: 437–453.
Dutrey-Dupagne C, Girard A, Ulmann A, Elghozi JL. Effects of the converting enzyme inhibitor trandolapril on short-term variability of blood pressure in essential hypertension.Clin Auto Res 1991;1: 303–307.
Bannister R, Mathias CJ. Introduction and classification of autonomic disorders. In: Bannister R, Mathias CJ, eds.Autonomic Failure. A Textbook of Clinical Disorders of the Autonomic Nervous System. 3rd ed. Oxford: Oxford University Press, 1992; 1–12.
Bernardi L, Calciati A, Gratarola A, Battistin I, Fratino P, Finardi G. Heart rate-respiration relationship: computerized method for early assessment of cardiac autonomic damage in diabetic patients.Acta Cardiol 1986;41: 197–206.
Pagani M, Malfatto G, Pierini S et al. Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy.J Auton Nerv Syst 1988;23: 143–153.
Comi G, Natali Sora MG, Bianchi A et al. Spectral analysis of shortterm heart rate variability in diabetic patients.J Auton Nerv Syst 1990;30: S45-S49.
Bellavere F, Balzani I, De Masi G et al. Power spectral analysis of heart-rate variations improves assessment of diabetic cardiac autonomic neuropathy.Diabetes 1992;41: 633–640.
Bernardi L, Perlini S, Salvucci F et al. Does autonomic modulation explain heart rate variability in all conditions? In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Blood Pressure and Heart Rate Variability. Amsterdam: IOS Press, 1993; 143–152.
Weise F, Heydenreich F. Power spectrum analysis of heart rate in diabetic patients: a marker of autonomic dysfunction. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Computer Analysis of Cardiovascular Signals. Amsterdam: IOS Press, 1995: 283–292.
Lishner M, Akselrod S, Mor Avi V, Oz O, Divon M Ravid M. Spectral analysis of heart rate fluctuations. A non-invasive, sensitive method for the early diagnosis of autonomic neuropathy in diabetes mellitus.J Auton Nerv Syst 1987;19: 119–125.
Axelrod S, Lishner M, Oz O, Bernheim J, Ravid M. Spectral analysis of fluctuations in heart rate: an objective evaluation of autonomic nervous control in chronic renal failure.Nephron 1987;45: 202–206.
Cloarec BL, Girard A, Houhou S, Grunfeld JP, Elghozi JL. Spectral analysis of short-term blood pressure and heart rate variability in uremic patients.Kidney Int 1992;37 (Suppl.): S14-S18.
Maayan C, Axelrod FB, Akselrod S, Carley DW, Shannon CD. Evaluation of autonomic dysfunction in familial dysautonomia by power spectral analysis.J. Auton Nerv Syst 1987;21: 51–58.
Man in 't Veld AJ, Boomsma F, Moleman P, Schalekamp MADH. Congenital dopamine β-hydroxylase deficiencyLancet 1987; i: 183–187.
Kingwell BA, Thompson JM, Kaye DM, McPherson GA, Jennings GL, Esler MD. Heart rate spectral analysis, cardiac norepinephrine spillover, and muscle sympathetic nerve activity during human sympathetic nervous activation and failure.Circulation 1994;90: 234–240.
Guzzetti S, Iosa D, Pecis M, Bonura L, Prosdocimi M, Malliani A. Impaired heart rate variability in patients with chronic Chagas' disease.Am Heart J 1991;121: 1727–1734.
Inoue K, Miyake S, Kumashiro M, Ogata H, Yoshimura O. Power spectral analysis of heart rate variability in traumatic quadriplegic humans.Am J Physiol 1990;258: H1722-H1726.
Inoue K, Miyake S, Kumashiro M, Ogata H, Ueta T, Akatsu T. Power spectral analysis of blood pressure variability in traumatic quadriplegic humans.Am J Physiol 1991;260: H842-H847.
Guzzetti S, Cogliati C, Broggi C et al. Infuences of neural mechanisms on heart period and arterial pressure variabilities in quadriplegic patients.Am J Physiol 1994;266: H1112-H1120.
Koh J, Brown TE, Beightol LA, Ha CY, Eckberg DL. Human autonomic rhythms: vagal cardiac mechanisms in tetraplegic subjects.J Physiol 1994;474: 483–495.
Vallbona C, Cardus D, Spencer WA Hoff HE. Patterns of sinus arrhythmia in patients with lesions of the central nervous system.Am J Cardiol 1965;16:379–389.
Lowensohn RI, Weiss M, Hon EH. Heart-rate variability in braindamaged adults.Lancet 1977;i: 626–628.
Moriguchi A, Otsuka A, Kohara K, Mikami H, Ogihara T. Evaluation of orthostatic hypotension using power spectral analysis.Am J Hypertens 1993;6: 198–203.
Barron SA, Rogovski Z, Hemli J. Autonomic consequences of cerebral hemisphere infarction.Stroke 1994;25:113–116.
Novak V, Novak P, de Marchie M, Schondorf R. The effect of severe brainstem injury on heart rate and blood pressure oscillations.Clin Auton Res 1995;5: 24–30.
Kita Y, Ishise J, Yoshita Y et al. Power spectral analysis of heart rate and arterial blood pressure oscillation in brain-dead patients.J Auton Nerv Syst 1993;44: 101–107.
Duncan G, Johnson RH, Lambie DG, Whiteside EA. Evidence of vagal neuropathy in chronic alcoholics.Lancet 1980;ii: 1053–1057.
Bernardi L, Ricordi L, Calciati A et al. Evidence of cardiac autonomic disease in chronic alcoholics by computerized study of heart rate-respiration relationship.Cardiologia 1986;31: 721–724.
O'Brien IAD, O'Hare P, Corrall RJM. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function.Br Heart J 1986;55: 348–354.
Schwartz JB, Gibb WJ, Tran T. Aging effects on heart rate variation.J Gerontol 1991;46: M99-M106.
Murata K, Landigran PJ, Araki S. Effects of age, heart rate, gender, tobacco and alcohol ingestion on R-R interval variability in human ECG.J Auton Nerv Syst 1992;37: 199–206.
Khoury S, Yarows SA, O'Brien TK, Sowers JR. Ambulatory blood pressure monitoring in a nonacademic setting: effects of age and sex.Am J Hypertens 1992;5: 616–623.
Drayer JIM, Weber MA, De Young JL, Wyle FA. Circadian blood pressure patterns in ambulatory hypertensive patients: effects of age.Am J Med 1982;73: 493–499.
Rowlands DB, Stallard TJ, Littler W. Continuous ambulatory monitoring of blood pressure and assessment of cardiovascular reflexes in the elderly hypertensive.J Hypertens 1984;2: 615–622.
Zito M, Parati G, Omboni S et al. Effect of aging on blood pressure variability.J Hypertens 1991;9 (suppl. 6): S328-S329.
Simpson DM, Wicks R. Spectral analysis of heart rate indicates reduced baroreceptor-related heart rate variability in elderly persons.J Gerontol 1988;43: M21-M24.
Kurkushko OV, Shatilo VB, Plachinda YI, Shatilo TV. Autonomic control of cardiac chronotropic function in man as a function of age: assessment by power spectral analysis of heart rate variability.J Auton Nerv Syst 1991;32: 191–198.
Veerman DP, Imholz BPM, Wieling W, Karemaker JM, van Montfrans GA. Effects of aging on blood pressure variability in resting conditions.Hypertension 1994;24: 120–130.
Shannon DC, Carley DW, Benson H. Aging of modulation of heart rate.Am J Physiol 1987;253: H874-H877.
Lipsitz LA, Mietus J, Moody GB, Goldberger AL. Spectral characteristics of heart rate variability before and during postural tilt. Relations to aging and risk of syncope.Circulation 1990;81: 1803–1810.
Ryan SM, Goldberger AL, Ruthazer R, Mietus J, Lipsitz LA. Spectral analysis of heart rate dynamics in elderly persons with postprandial hypotension.Am J Cardiol 1992;69: 201–205.
Lipsitz LA, Ryan SM, Parker JA, Freeman R, Wei JY, Goldberger AL. Hemodynamic and autonomic nervous system responses to mixed meal ingestion in healthy young and old subjects and dysautonomic patients with postprandial hypotension.Circulation 1993;87: 391–400.
Yo Y, Nagano M, Nagano N et al. Effects of age and hypertension on autonomic nervous regulation during passive head-up tilt.Hypertension 1994;23 (suppl. I): I-82–I-86.
Bradbury S, Eggleston C. Postural hypotension.Am Heart J 1925;1: 73–86.
Shy GM, Drager GA. A neurological syndrome associated with orthostatic hypotension.Arch Neurol 1960;3: 511–527.
Mancia G, Di Rienzo M, Parati G. Ambulatory blood pressure monitoring in hypertension research and clinical practice.Hypertension 1993;21: 510–524.
Di Rienzo M, Castiglioni P, Mancia G, Parati G, Pedotti A. 24 h sequential spectral analysis of arterial blood pressure and pulse interval in free-moving subjects.IEEE Trans Biomed Eng 1989;36: 1066–1075.
Parati G, Di Rienzo M, Omboni S, Castiglioni P, Frattola A, Mancia G. Spectral analysis of 24h blood pressure recordings.Am J Hypertens 1993;6:188S-193S.
Di Rienzo M, Parati G, Castiglioni P, Mancia G, Pedotti A. The wide band spectral analysis: a new insight into modulation of blood pressure, heart rate and baroreflex sensitivity. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Computer Analysis of Cardiovascular Signals. IOS Press: Amsterdam, 1995: 67–74.
Persson PB, Ehmke H, Köhler WW, Kirchheim HR. Identification of major slow blood pressure oscillations in conscious dogs.Am J Physiol 1990;259: H1050-H1055.
Di Rienzo M, Parati G, Castiglioni P et al. Role of sinoaortic afferents in modulating blood pressure and pulse interval spectral characteristics in unanesthetized cats.Am J Physiol 1991;261 (Heart Circ.30): H1811-H1818.
Kobayashi M, Musha T. 1/f fluctuations of heartbeat period.IEEE Trans Biomed Eng 1982;29: 456–457.
Saul JP, Albrecht P, Berger RD, Cohen RJ. Analysis of long term heart rate variability: methods, 1/f scaling and implications.Comp Cardiol 1987;14: 419–422.
Castiglioni P, Frattola A, Parati G, Di Rienzo M. 1/f modelling of blood pressure and heart rate spectra: relations to ageing. In: Morucci JP, Plonsey R, Coatrieux JL, Laxminarayan S, eds.Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Paris: IEEE Engineering in Medicine and Biology Society, 1992; 465–466.
Marsh DJ, Osborn JL, Cowley AWJ. 1/f fluctuations in arterial pressure and regulation of renal blood flow in dogs.Am J Physiol 1990;258: F1394-F1400.
Wagner CD, Persson PB. Two ranges in blood pressure power spectrum with different 1/f characteristics.Am J Physiol 1994;267: H449-H454.
Musha T. 1/f fluctuations of the biological rhythm. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A eds.Computer Analysis of Cardiovascular Signals. Amsterdam: IOS Press, 1995; 81–94.
Gardner M. White and brown music, fractal curves and 1/f fluctuations.Sci Am 1978;238: 16–32.
Musha T, Katsurai K, Teramachi Y. Fluctuations of human tapping intervals.IEEE Trans Biomed Eng 1985;32: 578–582.
Musha T, Takeuchi H, Inoue K. 1/f fluctuations in the spontaneous spike discharge intervals of a giant snail neuron.IEEE Trans Biomed Eng 1983;30: 194–197.
Di Rienzo M, Castiglioni P, Parati G, Mancia G, Pedotti A. Effects of sino-aortic denervation on spectral characteristics of blood pressure and pulse interval variability: a wide-band approach.Med Biol Eng Comput 1995; in press.
Parati G, Di Rienzo M, Castiglioni P et al. Daily-life baroreflex modulation: new perspectives from computer analysis of blood pressure and heart rate variability. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Computer Analysis of Cardiovascular Signals. Amsterdam: IOS Press, 1995; 209–218.
Robbe HWJ, Mulder LJM, Rüddel H, Langewitz WA, Veldman JBP, Mulder G. Assessment of baroreceptor reflex sensitivity by means of spectral analysis.Hypertension 1987;10: 538–543.
Pagani M, Somers V, Furlan R et al. Changes in autonomic regulation induced by physical training in mild hypertension.Hypertension 1988;12: 600–610.
Parati G, Omboni S, Frattola A, Di Rienzo M, Zanchetti A, Mancia G. Dynamic evaluation of the baroreflex in ambulant subjects. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, eds.Blood Pressure and Heart Rate Variability. Amsterdam: IOS Press, 1993; 123–137.
Frattola A, Parati G Di Rienzo M, Castiglioni P, Pedotti A, Mancia G. Blood pressure and heart rate variability in the elderly: evaluation by computer analysis of ambulatory 24 hour intra-arterial recordings.High Blood Press 1994;3: 151–157.
Parati G, Frattola A, Di Rienzo M, Castiglioni P, Pedotti A, Mancia G. Effects of aging on 24-h dynamic baroreceptor control of heart rate in ambulant subjects.Am J Physiol 1995;268: H1606-H1612.
Wesseling KH, Settels JJ, Wieling W, van Montfrans GA, Karemaker JM. The baromodulation hypothesis, baroreflex resetting and 1/f blood pressure spectra. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A, edsComputer Analysis of Cardiovascular Signals. Amsterdam: IOS Press, 1995; 105–118.
Imholz BPM, Langewouters GJ, van Montfrans GA et al. Feasibility of ambulatory, continous 24-hour finger arterial pressure recording.Hypertension 1993;21: 65–73.
Omboni S, Smit AAJ, Wieling W. Twenty four hour continuous non-invasive finger blood pressure monitoring: a novel approach to the evaluation of treatment in patients with autonomic failureBr Heart J 1995;73: 290–292.
Wesseling KH, de Wit B, Settels JJ, Klawer WH On the indirect registration of finger blood pressure after Peñáz.Funkt Biol Med 1982;1:245–250.
Parati G, Casadei R, Groppelli A, Di Rienzo M, Mancia G. Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing.Hypertension 1989;13: 647–655.
Imholz BPM, Wieling W, Langewouters GJ, van Montfrans GA. Continuous finger arterial pressure: utility in the cardiovascular laboratory.Clin Auton Res 1991;1:43–53.
Peñáz J. Photoelectric measurement of blood pressure, volume and flow in the finger. In: Albert A, Vogt W, Helbig W, edsDigest of the 10th International Conference on Medical and Biological Engineering. Dresden: International Federation for Medical and Biological Engineering, 1973; 104.
Omboni S, Parati G, Frattola A et al. Spectral and sequence analysis of finger blood pressure variability. Comparison with analysis of intra-arterial recordings.Hypertension 1993;22: 26–33.
Omboni S, Parati G, Di Rienzo M et al. 24h blood pressure variability in ambulant subjects: evaluation by continuous non-invasive finger blood pressure monitoring.Eur Heart J 1994;15 (abstract suppl.): 290 (Abstract).
Mann S, Altman DG, Raftery EB, Bannister R. Circadian variation of blood pressure in autonomic failure.Circulation 1983;68: 477–483.
Tulen JHM, Man in't Veld AJ, van Steenis HG, Mechelse K. Sleep patterns and blood pressure variability in patients with pure autonomic failure.Clin Auton Res 1991;1: 309–315.
Tochikubo O, Miyazaki N, Kaneko Y. Relationship between 24-hour arterial pressure and heart rate variation in normotensives, hypertensives and patients with Shy-Drager syndrome.Jpn Circ J 1987;51: 485–494.
Omboni S, Veerman DP, Parati G et al. 24 hour blood pressure variability in pure autonomic failure assessed by continuous non invasive recording.J Hypertens 1994;12 (suppl 3)S106 (Abstract).
Saul JP, Rea RF, Eckberg DL, Berger RD, Cohen RJ. Heart rate and muscle sympathetic nerve variability during reflex changes of autonomic activity.Am J Physiol 1990;258: H713-H721.
Arai Y, Saul JP, Albrecht P et al. Modulation of cardiac autonomic activity during and immediately after exercise.Am J Physiol 1989;256: H132-H141.
Daffonchio A, Franzelli C, Di Rienzo M et al. Effect of sympathectomy on blood pressure variability in the conscious rat.J Hypertens 1991;9 (suppl. 6): S70-S71.
Cerutti C, Gustin MP, Paultre CZ et al Autonomic nervous system and cardiovascular variability in rats: a spectral analysis approach.Am J Physiol 1991;261; H1292-H1299.
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Omboni, S., Parati, G., Di Rienzo, M. et al. Blood pressure and heart rate variability in autonomic disorders: a critical review. Clinical Autonomic Research 6, 171–182 (1996). https://doi.org/10.1007/BF02281905
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DOI: https://doi.org/10.1007/BF02281905