Neurocardiology: the benefits of irregularity. The basics of methodology, physiology and current clinical applications.
Cardiovascular variability in heart rate and blood pressure can be used to quantify the autonomic modulation of cardiovascular function. Although the first studies were only published 10 to 20 years ago, there is presently a vast amount of knowledge from numerous publications that allows a better insight into the neural control mechanisms of the heart. The development of methods such as heart rate variability and baroreflex sensitivity prompted a multidisciplinary approach since many aspects were involved: mathematics, signal processing, physiology and cardiology. Therefore, it is obvious that an adequate understanding of certain basic principles is necessary before its clinical potential can be fully exploited. This current review outlines the physiological background and the fundamental methodology used in the field of neurocardiology by presenting the newer insights and developments from both fundamental and clinical sides. Recent publications indicate that neurocardiological applications in (risk stratification of) myocardial infarction, congestive heart failure and heart transplant patients can be expected to enter daily clinical practice in the next millennium.
Aubert
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Dept. of Cardiology, University Hospital, K.U. Leuven, Belgium. Andre.Aubert@med.kuleuven.ac.be
Ramaekers
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D017704:Baroreflex / Q000502:physiology; D002319:Cardiovascular System / Q000294:innervation*; D006321:Heart / Q000294:innervation; D006329:Heart Conduction System / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology; D010275:Parasympathetic Nervous System / Q000502:physiology; D013564:Sympathetic Nervous System / Q000502:physiology