Time domain baroreflex sensitivity assessment by joint analysis of spontaneous SBP and RR series

The sequences technique is frequently used for time domain assessment of the arterial-cardiac baroreceptor reflex sensitivity (BRS). The BRS is estimated by the slope between systolic blood pressure and RR interval values in baroreflex sequences (BSs) and an overall estimate is obtained by slope averaging. However, only 25% of all beats are in BSs with 60% of those located in 3-beat length segments. Also, in cases of BSs absence (usually associated with poor BRS function), the BRS cannot be quantified.Here, baroreflex events (BEs) are introduced and used with global/total slope estimators to improve BRS assessment. The performance of the novel method is evaluated using the EuroBaVar dataset. The events technique benefits from a higher number of beats: 50% of all beats are in BEs with more than 70% exceeding 3-beat length. It always provides a BRS estimate, even when BSs cannot be identified. When BSs are available, estimates from BEs and BSs are highly correlated. The estimates from BEs for the cases without BSs are lower than the estimates for the remaining cases, indicating poorer BRS function. The events technique also offers superior ability to discriminate lying from standing position in the EuroBaVar dataset (23/23 versus 18/23 for the sequences technique).