The effect of change in sympatho-vagal balance on heart rate and blood pressure variability in the foetal lamb

Cardiac and vascular function is mainly under autonomic nervous control within seconds to minutes, although the control is not mature at birth. We studied sympathovagal control of heart rate and blood pressure in chronically catheterized foetal lambs in the last trimester of gestation. Power spectral analysis was used to quantitate the frequency-specific heart rate variability (HRV) and blood pressure variability. We performed 15 experiments in seven foetal lambs. These preliminary studies showed that parasympathetic blockade by atropine (eight experiments) had no significant effect on the distribution of HRV to different frequencies. Beta-sympathetic blockade by propranolol (seven experiments) decreased the ratio of low and mid to high frequency (0.025-0.13 to 0.13-1.00 Hz) HRV (P = 0.02). The increased high frequency HRV in the absence of a similar increase in blood pressure variability and tracheal pressure variability suggests enhanced baroreflex responsiveness after propranolol administration. The frequency-specific sympathetic control of HRV in foetal lambs, the change in ratio of low and mid to high frequency HRV, might have clinical implications in estimating the level of foetal sympathetic activation in the follow-up of high-risk pregnancies.

Association of breathing movements to the variability of heart rate and blood pressure in foetal lambs

Heart rate (HR) variability and arterial blood pressure (BP) variability were analysed as functions of foetal breathing movements (FBMs) by means of power spectral analysis in seven foetal lambs during the third trimester of gestation. No evidence of FBM-related changes, either in mean HR, mean systolic or diastolic arterial pressures, were found. Mean arterial pulse pressure, HR variability, and BP variability increased during FBMs. The increase in BP variability occurred at frequencies higher than 0.35 Hz, i.e. those of FBMs. The increase in HR variability occurred at 0.07-1.0 Hz, i.e. at every frequency band except the lowest one. Thus, the increase in HR variability was not frequency-specifically related to FBMs. During FBMs the periodic variability of HR at frequencies > 0.35 Hz was only 10% of total HR variability. We suggest that the FBM-related changes of BP variability may be mediated by direct peripheral, hydraulic mechanisms. HR changes involve autonomic control systems: the vagal component of baroreflex seems to be relatively insensitive, whereas the very slow vasomotor component of HR variability is dominant.

Multivariate autoregressive modeling of autonomic cardiovascular control in neonatal lamb

The neonatal cardiovascular control system is a complicated interactive system which is under vigorous development at birth. From the measurement point of view the cardiovascular control is a closed-loop system. However, it can be examined on a beat-by-beat basis by analyzing circulatory-controlled variables with advanced signal analysis techniques. This paper proposes to use a multivariate autoregressive modeling technique in the analysis of several simultaneous physiological signals in order to examine interactions and inherent properties in the system. With the proposed multivariate autoregressive modeling technique, a signal is modeled as a linear combination of its own past and the past values of the other simultaneous signals plus a predictive error term of the model. The interactions in the system after the model identification are analyzed in frequency domain utilizing power spectrum estimates of the signals and signal contributions. The applicability of the proposed method was examined by a three-variable model between heart rate, blood pressure and respiration in the study of autonomic cardiovascular control in a chronic neonatal lamb model, in which the cardiovascular status was changed by using a beta-adrenergic autonomic nervous blockade. The study showed that the multivariate autoregressive modeling technique is a feasible technique in studying complicated interactions within the cardiovascular control system.

Plasma renin substrate and oestrogens in normal pregnancy

Relationship between concentrations of serum oestrogens, plasma renin substrate and plasma renin activity were studied in six women throughout pregnancy. There was a significant positive correlation between serum oestradiol-17 beta and plasma renin substrate concentrations (r=0.60). Serum oestriol concentrations also correlated significantly with plasma renin substrate concentrations (r = 0.68). Correlation coefficients calculated separately for each subject throughout pregnancy were higher than those for the whole group. Also, there was much individual variation in dose-response of serum oestrogens to plasma renin substrate concentrations. There was no significant correlation between serum oestrogens and plasma renin activity. Our results support the view that oestrogens cause the increase in plasma renin substrate concentration during pregnancy, and emphasize the individual variation in response of renin substrate concentration to serum level of oestrogens.

Antepartal analysis of fetal heart rate variability by abdominal electrocardiography

The success rate of some methodological factors influencing the antepartal analysis of fetal heart rate variability (FHRV) by abdominal electrocardiography (aFECG) were studied in 80 normal and 554 high risk pregnancies. The success rate of FHRV analysis was found to be dependent on the gestational age with virtually 100% success at 22 to 25 weeks and at 40 to 41 weeks of gestation. The lowest rate of success, 50% was found around the 30th week of gestation (Fig. 1). The fifteen-degree lateral tilt and the supine position of the mother were found to be equal respecting the success rate and the test results, while the 90-degree lateral tilt was found to be less favorable for the analysis. FHRV analysis succeeded more often with electrode paste than it did with tap water moistening or with dry electrodes. The rejection limit of maximum interval differences in FHRV analysis was found to be an important factor influencing the test results. The variability indices should be compared only if they have been measured with the same rejection logic. Differential index, of short-term variability, can be measured from short samples of aFECG, having a good correlation between DIs measured using 1-minute, 5-minute and 20-minute samples (Figs. 3, 4). On the other hand, interval index measuring the long-term variability should be measured using longer samples of aFECG.