Baroreflex gain measured by the phenylephrine method and by the Robbe spectral technique in post-myocardial infarction patients

In this study compared the baroreflex gain (BRG) measured by the spectral method proposed by Robbe (1987) with the standard phenylephrine method in a population of 43 post-infarction patients (mean age/spl plusmn/SD: 52/spl plusmn/8). The agreement between the two techniques was assessed computing the bias (i.e. the mean value of the difference) and the 95% limits of agreement, whereas the degree of linear association has assessed by correlation analysis. The Pearson correlation coefficient was 0.67. The estimated limits of agreement were: -10.5/spl divide/5.5 ms/mmHg with a bias of -1 ms/mmHg (N.S.). As the difference between the two measurements was found to depend on their mean value (which is an estimate of the true BRG), the authors performed the same analysis on the percentage difference. The corresponding limits of agreement were -93.6/spl divide/88.5% with a bias of -2.6%. According to these results. The difference between the two measurements can be almost as large as the BRG of the patient. The authors' conclusion is that the spectral technique can substitute the pharmacological measurement for screening purposes but not in the assessment of patient prognosis where a depressed phenylephrine BRG (<3 ms/mmHg) has an important independent prognostic value.