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Heart rate and blood pressure variability in cardiac diseases: pharmacological implications
1Service de Pharmacologie Clinique, Hôpital Henri Mondor, Créteil, France.
Insights
Heart rate variability (HRV) is a key indicator of autonomic control in cardiovascular disease, aiding prognosis and treatment assessment. Blood pressure variability (BPV) is less studied but shows potential with new noninvasive recording methods.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Biomedical Engineering
Background:
- Continuous physiological fluctuations, such as heart rate and blood pressure, occur even at rest.
- Spontaneous fluctuations in heart rate variability (HRV) and blood pressure variability (BPV) are assessed using time or frequency domain indexes.
- HRV is a well-established parameter in cardiovascular disease, reflecting autonomic cardiovascular control.
Purpose of the Study:
- To highlight the established role of HRV in cardiovascular disease management.
- To emphasize the under-investigated potential of BPV due to recent advancements in noninvasive continuous blood pressure monitoring.
Main Methods:
- Analysis of time and frequency domain indexes for assessing HRV and BPV.
- Utilizing noninvasive methods for continuous blood pressure recording.
Main Results:
- HRV has been extensively studied and is valuable for detecting autonomic abnormalities, prognosis, and assessing drug therapy impact in conditions like myocardial infarction, heart failure, and post-heart transplant.
- BPV has received limited attention historically, pending the development of reliable noninvasive continuous recording techniques.
Conclusions:
- HRV is a crucial biomarker in cardiovascular disease, offering insights into autonomic function and patient outcomes.
- BPV represents a promising, yet under-evaluated, parameter for cardiovascular disease assessment, with potential for future research and clinical application.
Abstract:
Even at rest, blood pressure and heart fluctuate continuously around their mean values. Considerable interest has recently focused on the assessment of spontaneous in fluctuations in heart rate and blood pressure, i.e., heart rate and blood pressure variability, using time or frequency domain indexes. Heart rate variability has been extensively studied in cardiovascular disease and has emerged as a valuable parameter for detecting abnormalities in autonomic cardiovascular control, evaluating the prognosis and assessing the impact of drug therapy on the autonomic nervous system in patients with myocardial infarction, congestive heart failure or a heart transplant. In contrast, until the recent development of noninvasive methods for continuous blood pressure recording, blood pressure variability received little attention, and this parameter remains to be evaluated in cardiovascular disease.