Concomitant evaluation of cardiovascular and cerebrovascular controls via Geweke spectral causality to assess the propensity to postural syncope
Articolo
Data di Pubblicazione:
2023
Citazione:
Concomitant evaluation of cardiovascular and cerebrovascular controls via Geweke spectral causality to assess the propensity to postural syncope / A. Porta, F. Gelpi, V. Bari, B. Cairo, B. De Maria, D. Tonon, G. Rossato, L. Faes. - In: MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING. - ISSN 0140-0118. - 61:12(2023), pp. 3141-3157. [10.1007/s11517-023-02885-0]
Abstract:
The evaluation of propensity to postural syncope necessitates the concomitant characterization of the cardiovascular and
cerebrovascular controls and a method capable of disentangling closed loop relationships and decomposing causal links in
the frequency domain. We applied Geweke spectral causality (GSC) to assess cardiovascular control from heart period and
systolic arterial pressure variability and cerebrovascular regulation from mean arterial pressure and mean cerebral blood
velocity variability in 13 control subjects and 13 individuals prone to develop orthostatic syncope. Analysis was made at
rest in supine position and during head-up tilt at 60°, well before observing presyncope signs. Two different linear model
structures were compared, namely bivariate autoregressive and bivariate dynamic adjustment classes. We found that (i) GSC
markers did not depend on the model structure; (ii) the concomitant assessment of cardiovascular and cerebrovascular con-
trols was useful for a deeper comprehension of postural disturbances; (iii) orthostatic syncope appeared to be favored by the
loss of a coordinated behavior between the baroreflex feedback and mechanical feedforward pathway in the frequency band
typical of the baroreflex functioning during the postural challenge, and by a weak cerebral autoregulation as revealed by the
increased strength of the pressure-to-flow link in the respiratory band. GSC applied to spontaneous cardiovascular and cer-
ebrovascular oscillations is a promising tool for describing and monitoring disturbances associated with posture modification.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Arterial pressure; Baroreflex; Blood flow; Cerebral autoregulation; Head-up tilt; Heart rate variability; Postural syncope; Vector autoregressive model
Elenco autori:
A. Porta, F. Gelpi, V. Bari, B. Cairo, B. De Maria, D. Tonon, G. Rossato, L. Faes
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