Spontaneous Baroreflex Sensitivity: From the Cardiovascular Laboratory to Patient's Bedside

The sensitivity of the baroreceptor-heart rate reflex has been suggested to have a prognostic value in a number of diseases. In particular, mortality after myocardial infarction, in heart failure patients and in diabetic patients seems to be inversely related to the sensitivity of cardiac baroreflex modulation. These data were obtained, however, by means of traditional laboratory tests, which are affected by important limitations. A deeper insight into the features of daily life baroreflex cardiovascular control can now be obtained by techniques which allow spontaneous baroreflex sensitivity to be assessed in daily life conditions, without need of any intervention on the patient. The various methods currently available to assess spontaneous baroreflex sensitivity are hereby discussed, focusing on the similarities and differences between them and with the traditional laboratory approaches. In particular, the characteristic features and the possible clinical usefulness of the sequence method will be discussed more in details.