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Cardiac Output II: Effect of Stroke Volume on Cardiac Output

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Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
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Investigating the relationship between cardiac interoception and autonomic cardiac control using a predictive coding

Andrew P Owens¹, Karl J Friston², David A Low³

¹Lab of Action & Body, Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UK; Institute of Neurology, University College London, London WC1N 3BG, UK; National Hospital Neurology and Neurosurgery, UCL NHS Trust, London WC1N 3BG, UK.

Autonomic Neuroscience : Basic & Clinical

|January 15, 2018

Summary

This summary is machine-generated.

Predictive coding explains how the brain uses interoception to maintain body balance. Orthostatic intolerance patients show deficits in this process, failing to adjust autonomic responses.

Keywords:

Active inference Autonomic nervous system Dysautonomia Free-energy principle Heart rate variability Homeostasis Interoception Interoceptive (active) inference Predictive coding

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Area of Science:

Neuroscience
Physiology
Psychology

Background:

Predictive coding models, like the free-energy principle (FEP), explore how interoceptive signals update bodily state predictions.
Interoceptive inference, under FEP, offers insights into autonomic dysfunction and brain-body integration.
Orthostatic intolerance (OI) encompasses conditions like postural tachycardia syndrome (PoTS) and vasovagal syncope (VVS), characterized by autonomic dysregulation.

Purpose of the Study:

To investigate the relationship between cardiac interoception and autonomic cardiac control in healthy individuals and OI patients.
To find empirical support for interoceptive inference in the context of autonomic function.
To determine if this relationship is affected by increased interoceptive prediction error in OI patients during head-up tilt (HUT).

Main Methods:

Measures of interoception and heart rate variability (HRV) were collected from healthy controls (N=20), PoTS patients (N=20), and VVS patients (N=20).
Data were recorded in supine and head-up tilt (HUT) positions to simulate symptom provocation.
Interoceptive accuracy, sensibility, and awareness were assessed alongside autonomic cardiac control (HRV).

Main Results:

Interoceptive accuracy was significantly reduced in both OI groups compared to healthy controls.
Healthy controls showed a positive correlation between interoceptive sensibility and HRV when supine.
OI groups exhibited a negative correlation between interoceptive awareness and HRV during HUT, indicating altered autonomic response.

Conclusions:

The study provides initial support for interoceptive inference as a framework for understanding autonomic (dys)function.
OI patients may share a common pathophysiology involving interoceptive deficits impacting cardiovascular autonomic control.
Findings suggest OI involves a failure to modulate interoceptive prediction errors and engage appropriate autonomic reflexes during physiological stress.