Cardiorespiratory coupling in health and disease

Abstract

Cardiac and respiratory activities are intricately linked both functionally as well as anatomically through highly overlapping brainstem networks controlling these autonomic physiologies that are essential for survival. Cardiorespiratory coupling (CRC) has many potential benefits creating synergies that promote healthy physiology. However, when such coupling deteriorates autonomic dysautonomia may ensue. Unfortunately there is still an incomplete mechanistic understanding of both normal and pathophysiological interactions that respectively give rise to CRC and cardiorespiratory dysautonomia. Moreover, there is also a need for better quantitative methods to assess CRC. This review addresses the current understanding of CRC by discussing: (1) the neurobiological basis of respiratory sinus arrhythmia (RSA); (2) various disease states involving cardiorespiratory dysautonomia; and (3) methodologies measuring heart rate variability and RSA.

In vivo cardiac phase response curve elucidates human respiratory heart rate variability

“…Furthermore, as the duration of electric diastole mainly determines the heart rate 53 , the amplitude of PRC can be considered as a measure of adaptability in response to respiratory drive; adaptation of the heart rate is a fundamental prerequisite of the proper functioning of the cardiovascular system. Therefore, quantification of variations of the PRC in amplitude or shape might be helpful for diagnostic of various disease states involving cardiorespiratory dysautonomia 54 . Further statistical studies of PRC dependence on the age, gender and other factors are needed here.…”

Peripheral chemoreceptors tune inspiratory drive via tonic expiratory neuron hubs in the medullary ventral respiratory column network

“…Numerous disorders of breathing and cardio-respiratory coupling are associated with dysfunctional chemoreceptor drive mechanisms (Dempsey and Smith 2014;Garcia et al 2013;Perez and Keens 2013;Plataki et al 2013). Brain mechanisms that mediate the separate and joint actions of central chemoreceptors, sensors of brain CO 2 and pH, and the peripheral chemoreceptors are topics of active research and debate (Duffin and Mateika 2013; Nuding et al 2009b;Teppema and Smith 2013;Wilson and Day 2013).…”

Kangaroo care: cardio-respiratory relationships between the infant and caregiver

“…Though respiration and heart rate are under the control of two independent systems, coordination between the two has been shown to reflect health and maturation [31,32]. Cardio-respiratory coupling quantifies the interaction between respiratory and heart rhythms.…”

“…We propose that during KC, wherein the infant's head and chest wall overlay the chest wall of the caregiver, mechanical perturbations of the caregiver's heartbeat affect underlying receptors of the cohabitating infant. These receptors might include cutaneous, musculoskeletal, visceral and vestibular-cochlear receptors that project to brain centers that are involved in respiratory control [31][32][33][34][35]. This study tested the hypothesis that respiratory stability of the premature infant is influenced by sensory perturbations of the caregiver's heart beat during KC.…”