Heart rate: control mechanisms, pathophysiology and assessment of the neurocardiac system in health and disease

Abstract

The monitoring of physiological function and dysfunction is an important principle in modern medicine. Heart rate is a basic example of this type of observation, particularly assessing the neurocardiac system, which entails the autonomic nervous system and intracardiac processes. The neurocardiac axis is an underappreciated and often overlooked system which, if measured appropriately in the clinical setting, may allow identification of patients at risk of disease progression and even mortality. While heart rate itself is a simplistic tool, more information may be gathered through assessing heart rate variability and heart rate recovery time. Studies have demonstrated an association of slow heart rate recovery and lower heart rate variability as markers of elevated sympathetic and lower parasympathetic tone. These parameters have additionally been shown to relate to development of arrhythmia, heart failure, systemic inflammatory processes, ischaemic heart disease and an increased rate of mortality. The aim of this review is to detail how heart rate is homeostatically controlled by the autonomic nervous system, how heart rate can impact on pathophysiological processes, and how heart rate variability and heart rate recovery time may be used in the clinical setting to allow the neurocardiac system to be assessed.

Psychosocial Stress Modifies the Acute Cardiac Health Effects of Traffic-Related Air Pollution

“…These results suggest that HR tended to show more apparent marginal increases, whereas HRV variables, including SDNN, LF and HF, tended to show more apparent marginal decreases, in association with BC exposure under a higher composite stress index. In view that increased HR and decreased HRV variables can reflect autonomic dysfunction, predict arrhythmia, and have been associated with increased morbidity and mortality of ischemic heart disease, − our results suggest that psychosocial stress could potentially enhance the cardiac autonomic dysfunction and relevant cardiac risk associated with BC exposure. The modifying effect pattern identified using the individual stress scales appeared to be less consistent and evident compared to that of the composite stress index.…”

“…These variables are important indicators of cardiac health, and their alterations have been associated with a variety of adverse cardiovascular events. For example, ST-segment depression events indicate myocardial ischemia and can predict onset of myocardial infarction, − while increased HR and decreased HRV variables can reflect autonomic dysfunction, predict arrhythmia, and have been associated with increased morbidity and mortality of ischemic heart disease. − …”

Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID

“…Our overview here is very far from being comprehensive, and our focus is necessarily on short-term control, where the autonomic nervous system is predominant (Figure 1, after [92]). by many genetic and lifestyle factors (e.g., [92,93]), and the required kinds of understanding are both conceptual (e.g., the need to cater for the time-varying demands of tissue oxygenation) and mechanistic (e.g., the involvement of the endocrine and autonomic nervous systems). Our overview here is very far from being comprehensive, and our focus is necessarily on short-term control, where the autonomic nervous system is predominant (Figure 1, after [92]).…”

Frecuencia cardiaca: una revisión sistemática

“…La FC bajo estrés agudo en adultos, pueden alterar la magnitud de la FC y su complejidad en respuesta al estrés, al intensificar la reactividad cardiaca al estrés y limitar la complejidad del corazón, lo que de forma eventual atribuiría un riesgo para la salud 7 . La FC es uno de los índices fisiológicos que varía en función de influencias fisiológicas y fisiopatológica, se han observado alteraciones en multitud de patologías, como la aterosclerosis coronaria, la insuficiencia cardiaca sistólica, la sepsis y la inflamación sistémica 8 .…”