Cardiovascular control in women with fibromyalgia syndrome: do causal methods provide nonredundant information compared with more traditional approaches?
The cardiovascular autonomic control and the baroreflex sensitivity (BRS) have been widely studied in fibromyalgia syndrome (FMS) patients through the computation of linear indices of spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities. However, there are many methodological difficulties regarding the quantification of BRS by the traditional indices especially in relation to the issue of causality. This difficulty has been directly tackled via a model-based approach describing the closed-loop HP-SAP interactions and the exogenous influences of respiration. Therefore, we aimed to assess whether the BRS assessed by the model-based causal closed-loop approach during supine and active standing in patients with FMS could provide complementary information to those obtained by traditional indices based on time and frequency domains. The findings of this study revealed that, at difference with the traditional methods to quantify BRS, the causality analysis applied to the HP, SAP, and respiratory series, through the model-based closed-loop approach, detected lower BRS in supine position, as well as a blunted response to the orthostatic stimulus in patients with FMS compared with healthy control subjects. Also, the strength of the causal relation from SAP to HP (i.e., along the cardiac baroreflex) increased during the active standing only in the control subjects. The model-based closed-loop approach proved to provide important complementary information about the cardiovascular autonomic control in patients with FMS.
['Zamunér|Antonio Roberto|AR|http://orcid.org/0000-0002-7480-3047', 'Porta|Alberto|A|http://orcid.org/0000-0002-6720-9824', 'Andrade|Carolina Pieroni|CP|', 'Marchi|Andrea|A|', 'Forti|Meire|M|', 'Furlan|Raffaello|R|', 'Barbic|Franca|F|', 'Catai|Aparecida Maria|AM|', 'Silva|Ester|E|']
D000328:Adult D062186:Arterial Pressure D001341:Autonomic Nervous System D017704:Baroreflex D002319:Cardiovascular System D016022:Case-Control Studies D004562:Electrocardiography D005260:Female D005356:Fibromyalgia D006334:Heart Function Tests D006339:Heart Rate D006801:Humans D008875:Middle Aged D008955:Models, Cardiovascular D056888:Patient Positioning D011237:Predictive Value of Tests D012737:Sex Factors D019722:Sphygmomanometers D016683:Supine Position D013997:Time Factors
fibromyalgia causality baroreflex autonomic nervous system modeling