Estimation of baroreflex sensitivity using pulse arrival time rather than systolic blood pressure measurement

Baroreflex sensitivity (BRS) is a parameter of the cardiovascular system that is reflected in changes in pulse interval (PD and systolic blood pressure (SBP). BRS contains information about how the autonomic nervous system regulates hemodynamic homeostasis. Normally the beat-to-beat SBP measurement and the pulse interval measured from the electrocardiogram (ECG) are required to estimate the BRS. We investigated the possibility of measuring BRS in the absence of a beat-to-beat SBP measurement device. Pulse arrival time (PAT), defined as the time between the R-peak of the ECG and a single characteristic point on the pulse wave recorded from any arterial location was measured by photoplethysmography. By comparing the BRS obtained from conventional measurements with our method during controlled breathing, we confirmed again that PAT and SBP are closely correlated, with a correlation coefficient of -0.82 to -0.95. The coherence between SBP and PI at a respiration frequency of 0.07-0.12 Hz was similar to the coherence between PAT and PI. Although the ranges and units of measurement are different (ms/mmHg vs. ms/ms) for BRS measured conventionally and by our method, the correlation is very strong. Following further investigation under various conditions, BRS can be reliably estimated without the inconvenient and expensive beat-to-beat SBP measurement.