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ORIGINAL RESEARCH article

Front. Physiol.

Sec. Autonomic Neuroscience

Autonomic and baroreflex regulations in syndromic and non-syndromic aortopathies: a case control study

Provisionally accepted
Beatrice CairoBeatrice Cairo1Nathasha Samali UdugampolageNathasha Samali Udugampolage2Francesca GelpiFrancesca Gelpi1,3Vlasta BariVlasta Bari1,3*Paolo SalviPaolo Salvi4Miriam AngolaniMiriam Angolani2Jacopo TaurinoJacopo Taurino2Alberto PortaAlberto Porta1,3Alessandro PiniAlessandro Pini2
  • 1Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
  • 2Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
  • 3Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy
  • 4Cardiology Unit, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy

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Baroreflex regulation is directly influenced by mechano-sensitive properties of the baroreceptors. In thoracic aortic aneurysm (TAA) patients mechanical and dimensional properties of the aorta are affected. We hypothesize that baroreflex sensitivity (BRS) was modified in TAA patients and modifications might be different when TAA group was divided into syndromic (Synd) and non-syndromic (NonSynd) patients. The aim of the study is to appraise autonomic and baroreflex control in patients with Synd and NonSynd TAAs. We enrolled eighty TAA patients divided into Synd (N=46) and NonSynd (N=34) patients. The two groups did not differ for either demographic factors or pharmacological therapy. The autonomic function and BRS assessed from heart period (HP) and systolic arterial pressure (SAP) variability were compared to those of age- and gender-matched healthy controls (HCs, N=28). Analyses were carried out in low frequency (LF, 0.04-0.15 Hz) and high frequency (HF, 0.15-0.4 Hz) bands. Synd and NonSynd subgroups did not show any significant differences in terms of either autonomic control or BRS. We observed that in the LF band BRS was lower in TAA than in HC at REST, while it was similar during STAND. STAND reduced the power of HP variability in the HF band and BRS in the LF band, while increasing the power of SAP in LF band in both HCs and TAA patients. Since BRS was lower at REST in both Synd and NonSynd TAA groups than in HC group, we conclude that BRS is affected by the dimensional and/or mechanical properties of the aorta in relation to the pathology.

Keywords: Autonomic Nervous System, baroreflex sensitivity, cardiac control, Heart rate variability, heritable connective tissue disorders, thoracic aorticaneurysm

Received: 06 Oct 2025; Accepted: 03 Dec 2025.

Copyright: © 2025 Cairo, Udugampolage, Gelpi, Bari, Salvi, Angolani, Taurino, Porta and Pini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Vlasta Bari

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