Relation of the baroreflex mechanism with the photoplethysmographic volume in healthy humans during orthostatism.

OBJECTIVE Our aim was to evaluate the effect of the baroreflex mechanism upon peripheral blood volume during sympathetic stimulation by orthostatism. METHODS Nineteen clinically healthy volunteers were included (12 men), 28.4 ± 6.2 years old. Blood pressure was monitored with a Finometer and blood volume with a photoplethysmograph during supine position and orthostatism (15 minutes each), in order to obtain systolic blood pressure (SBP), diastolic blood pressure (DBP), systolic volume (SysV), diastolic volume (DiaV), and inter beat intervals (IBI) measurements. Baroreflex sensitivity index (IBI/SBP) and baroreflex effect on blood volume (IBI/SysV) were estimated by the sequence method. The pertinence of using only systolic values was tested by linear regression analysis of systolic versus diastolic measurements. RESULTS More than 70% of DBP and DiaV variations can be explained by SBP and SysV, respectively (p<0.001), with coherence >0.5 in frequencies between 0.04 and 0.15 Hz. IBI/SBP and IBI/SysV were linearly correlated (R>0.4) and both decreased during orthostatism (p<0.05). CONCLUSION The sequence method showed a strong baroreflex effect upon peripheral blood volume that became more apparent during sympathetic stimulation with orthostatism. This approach could be clinically useful for the evaluation of blood volume regulation for many diseases such as diabetes mellitus and heart failure, and during therapeutic interventions such as hemodialysis.