{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T12:23:53Z","timestamp":1775478233255,"version":"3.50.1"},"reference-count":35,"publisher":"Portland Press Ltd.","issue":"12","content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:p>Baroreceptor reflex sensitivity (BRS) is an important prognostic factor because a reduced BRS has been associated with an adverse cardiovascular outcome. The threshold for a \u2018reduced\u2019 BRS was established by the ATRAMI study at BRS &amp;lt;3\u00a0ms\/mmHg in patients with a previous myocardial infarction, and has been shown to improve risk assessment in many other cardiac dysfunctions. The successful application of this cut-off to other populations suggests that it may reflect an inherent property of baroreflex functioning, so our goal is to investigate whether it represents a \u2018natural\u2019 partition of BRS values. As reduced baroreflex responsiveness is also associated with ageing, we investigated whether a BRS estimate &amp;lt;3\u00a0ms\/mmHg could be the result of a process of physiological senescence as well as a sign of BRS dysfunction. This study involved 228 chronic heart failure patients and 60 age-matched controls. Our novel method combined transfer function BRS estimation and automatic clustering of BRS probability distributions, to define indicative levels of different BRS activities. The analysis produced a fit clustering (cophenetic correlation coefficient 0.9 out of 1) and identified one group of homogeneous patients (well separated from the others by 3\u00a0ms\/mmHg) with an increased BRS-based mortality risk [hazard ratio (HR): 3.19 (1.73, 5.89), P&amp;lt;0.001]. The age-dependent BRS cut-off, estimated by 5% quantile regression of log\u00a0(BRS) with age (considering the age-matched controls), provides a similar mortality value [HR: 2.44 (1.37, 4.43), P=0.003]. In conclusion, the 3\u00a0ms\/mmHg cut-off identifies two large clusters of homogeneous heart failure (HF) patients, thus supporting the hypothesis of a natural cut-off in the HF population. Furthermore, age was found to have no statistical impact on risk assessment, suggesting that there is no need to establish age-based cut-offs because 3\u00a0ms\/mmHg optimally identifies patients at high mortality risk.<\/jats:p>","DOI":"10.1042\/cs20150341","type":"journal-article","created":{"date-parts":[[2015,10,3]],"date-time":"2015-10-03T00:13:01Z","timestamp":1443831181000},"page":"1163-1172","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Spontaneous baroreceptor reflex sensitivity for risk stratification of heart failure patients: optimal cut-off and age effects"],"prefix":"10.1042","volume":"129","author":[{"given":"S\u00f3nia","family":"Gouveia","sequence":"first","affiliation":[{"name":"Institute of Electronics and Informatics Engineering of Aveiro (IEETA) and Center for R&D in Mathematics and Applications (CIDMA), Universidade de Aveiro (UA), Portugal"}]},{"given":"Manuel\u00a0G.","family":"Scotto","sequence":"additional","affiliation":[{"name":"CEMAT and Instituto Superior T\u00e9cnico, Universidade de Lisboa, Portugal"}]},{"given":"Gian\u00a0Domenico","family":"Pinna","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Fondazione Salvatore Maugeri\u2013IRCCS, Montescano, Italy"}]},{"given":"Roberto","family":"Maestri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Fondazione Salvatore Maugeri\u2013IRCCS, Montescano, Italy"}]},{"given":"Maria\u00a0Teresa","family":"La Rovere","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fondazione Salvatore Maugeri\u2013IRCCS, Montescano, Italy"}]},{"given":"Paulo\u00a0J.S.G.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Electronics, Telecommunications and Informatics (DETI) and IEETA, Universidade de Aveiro (UA), Portugal"}]}],"member":"288","published-online":{"date-parts":[[2015,10,30]]},"reference":[{"key":"2021113010574067800_B1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/j.1542-474X.2008.00219.x","article-title":"Baroreflex sensitivity: measurement and clinical implications","volume":"13","author":"La Rovere","year":"2008","journal-title":"Ann. 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