Display options
Cite
La Rovere MT, Porta A, Schwartz PJ. Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective. Front Physiol. 2020;11:582doi: 10.3389/fphys.2020.00582.
La Rovere, M. T., Porta, A., & Schwartz, P. J. (2020). Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective. Frontiers in physiology, 11582. https://doi.org/10.3389/fphys.2020.00582
La Rovere, Maria Teresa, et al. "Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective." Frontiers in physiology vol. 11 (2020): 582. doi: https://doi.org/10.3389/fphys.2020.00582
La Rovere MT, Porta A, Schwartz PJ. Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective. Front Physiol. 2020 Jun 12;11:582. doi: 10.3389/fphys.2020.00582. eCollection 2020. PMID: 32670079; PMCID: PMC7328903.
Copy Download .nbib Format: NLM
Share it on

Front Physiol. 2020 Jun 12;11:582. doi: 10.3389/fphys.2020.00582. eCollection 2020.

Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective.

Frontiers in physiology

Maria Teresa La Rovere, Alberto Porta, Peter J Schwartz

Affiliations

  1. Department of Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Montescano (Pavia), Italy.
  2. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
  3. Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
  4. Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy.

PMID: 32670079 PMCID: PMC7328903 DOI: 10.3389/fphys.2020.00582

Abstract

This essay covers several aspects of the autonomic control of the heart, all relevant to cardiovascular pathophysiology with a direct impact on clinical outcomes. Ischemic heart disease, heart failure, channelopathies, and life-threatening arrhythmias are in the picture. Beginning with an overview on some of the events that marked the oscillations in the medical interest for the autonomic nervous system, our text explores specific areas, including experimental and clinical work focused on understanding the different roles of tonic and reflex sympathetic and vagal activity. The role of the baroreceptors, not just for the direct control of circulation but also because of the clinical value of interpreting alterations (spontaneous or induced) in their function, is discussed. The importance of the autonomic nervous system for gaining insights on risk stratification and for providing specific antiarrhythmic protection is also considered. Examples are the interventions to decrease sympathetic activity and/or to increase vagal activity. The non-invasive analysis of the RR and QT intervals provides additional information. The three of us have collaborated in several studies and each of us contributes with very specific and independent areas of expertise. Here, we have focused on those areas to which we have directly contributed and hence speak with personal experience. This is not an attempt to provide a neutral and general overview on the autonomic nervous system; rather, it represents our effort to share and provide the readers with our own personal views matured after many years of research in this field.

Copyright © 2020 La Rovere, Porta and Schwartz.

Keywords: QT interval; autonomic nervous system; baroreflex sensitivity; heart rate variability; long QT syndrome; sudden death; sympathetic nervous system; vagal activity

References

  1. Science. 1981 Jul 10;213(4504):220-2 - PubMed
  2. J Physiol. 1973 Mar;229(2):457-69 - PubMed
  3. Heart Rhythm. 2017 Feb;14(2):302-303 - PubMed
  4. Circulation. 2003 Feb 4;107(4):565-70 - PubMed
  5. Circ Res. 1973 Feb;32(2):215-20 - PubMed
  6. Lancet. 2018 Jun 9;391(10137):2335-2345 - PubMed
  7. Am J Cardiol. 1983 Jul;52(1):55-9 - PubMed
  8. PLoS One. 2014 Apr 04;9(4):e93808 - PubMed
  9. Hypertension. 1987 Nov;10(5):538-43 - PubMed
  10. Ann Noninvasive Electrocardiol. 2008 Apr;13(2):191-207 - PubMed
  11. Circulation. 1997 Mar 18;95(6):1441-8 - PubMed
  12. Eur Heart J. 2011 Apr;32(7):847-55 - PubMed
  13. Lancet. 2017 Nov 11;390(10108):2160-2170 - PubMed
  14. Circ Heart Fail. 2015 May;8(3):619-28 - PubMed
  15. Curr Heart Fail Rep. 2019 Feb;16(1):38-46 - PubMed
  16. Circulation. 1997 Nov 18;96(10):3450-8 - PubMed
  17. JACC Clin Electrophysiol. 2019 Aug;5(8):881-896 - PubMed
  18. J Hypertens Suppl. 1985 Dec;3(3):S79-81 - PubMed
  19. Circulation. 1997 Nov 4;96(9):3224-32 - PubMed
  20. Circ Res. 1977 Jul;41(1):51-8 - PubMed
  21. Lancet. 2019 Oct 12;394(10206):1344-1351 - PubMed
  22. Circulation. 1980 Dec;62(6):1256-65 - PubMed
  23. Neuropsychobiology. 2000;41(3):113-23 - PubMed
  24. Eur Heart J. 2007 Jun;28(11):1344-50 - PubMed
  25. Prog Biophys Mol Biol. 2006 Nov;92(3):269-307 - PubMed
  26. Transl Res. 2006 Aug;148(2):72-8 - PubMed
  27. Am J Physiol Heart Circ Physiol. 2011 Apr;300(4):H1412-7 - PubMed
  28. J Electrocardiol. 2011 Nov-Dec;44(6):662-8 - PubMed
  29. Circ Res. 1991 Nov;69(5):1389-401 - PubMed
  30. Eur Heart J. 1996 Mar;17(3):354-81 - PubMed
  31. J Electrocardiol. 2004 Jul;37(3):173-9 - PubMed
  32. Circulation. 1998 Oct 6;98(14):1394-9 - PubMed
  33. Am J Cardiol. 1987 Feb 1;59(4):256-62 - PubMed
  34. JAMA. 2020 Jan 21;323(3):248-255 - PubMed
  35. Physiol Meas. 2017 Jun 27;38(7):1472-1489 - PubMed
  36. Am Heart J. 1976 Nov;92(5):589-99 - PubMed
  37. J Am Coll Cardiol. 2009 Aug 25;54(9):851-2 - PubMed
  38. J Appl Physiol (1985). 2007 Oct;103(4):1143-9 - PubMed
  39. Heart Rhythm. 2016 Jan;13(1):70-1 - PubMed
  40. J Am Coll Cardiol. 2007 Dec 11;50(24):2285-90 - PubMed
  41. Circ Res. 1979 May;44(5):637-45 - PubMed
  42. Eur Heart J. 2015 Aug 7;36(30):1974-82b - PubMed
  43. Eur Heart J. 2013 Jul;34(28):2149-57 - PubMed
  44. Int J Cardiol. 2017 Jun 15;237:2-5 - PubMed
  45. Circulation. 2001 Jan 2;103(1):89-95 - PubMed
  46. Am J Physiol. 1985 Jan;248(1 Pt 2):H151-3 - PubMed
  47. Circulation. 1988 Oct;78(4):969-79 - PubMed
  48. Heart Rhythm. 2009 Nov;6(11 Suppl):S25-33 - PubMed
  49. Circ Res. 1991 May;68(5):1191-203 - PubMed
  50. Circ Arrhythm Electrophysiol. 2011 Dec;4(6):858-66 - PubMed
  51. Eur Heart J. 1996 May;17(5):769-78 - PubMed
  52. Eur Heart J. 2014 Jul 1;35(25):1642-51 - PubMed
  53. J Am Coll Cardiol. 2015 Feb 03;65(4):367-374 - PubMed
  54. J Hypertens. 2018 Aug;36(8):1614-1621 - PubMed
  55. Cardiovasc Res. 2001 Jun;50(3):434-42 - PubMed
  56. Ergeb Physiol. 1963;52:74-156 - PubMed
  57. Am J Physiol. 1994 Apr;266(4 Pt 2):H1643-56 - PubMed
  58. Heart Fail Rev. 2017 Nov;22(6):657-664 - PubMed
  59. Philos Trans A Math Phys Eng Sci. 2009 Apr 13;367(1892):1215-8 - PubMed
  60. Am J Physiol Heart Circ Physiol. 2009 Oct;297(4):H1171-93 - PubMed
  61. Eur Heart J. 2015 Feb 14;36(7):425-33 - PubMed
  62. Am J Cardiol. 1982 Apr 1;49(5):1185-90 - PubMed
  63. J Physiol. 1972 Apr;222(1):1-15 - PubMed
  64. Circ Res. 2000 Apr 14;86(7):816-21 - PubMed
  65. Am J Cardiol. 1976 Jun;37(7):1034-40 - PubMed
  66. N Engl J Med. 2014 Apr 10;370(15):1393-401 - PubMed
  67. Rev Cardiovasc Med. 2018 Sep 30;19(3):89-95 - PubMed
  68. Lancet. 2018 Jun 9;391(10137):2346-2355 - PubMed
  69. J Physiol. 2019 May;597(10):2595-2598 - PubMed
  70. Europace. 2016 Jun;18(6):925-44 - PubMed
  71. J Am Coll Cardiol. 2002 Jun 5;39(11):1820-6 - PubMed
  72. Lancet. 1999 Apr 24;353(9162):1390-6 - PubMed
  73. Brain Res. 1974 Mar 22;68(2):215-25 - PubMed
  74. Circulation. 1982 Oct;66(4):874-80 - PubMed
  75. Clin Res Cardiol. 2012 Jan;101(1):63-7 - PubMed
  76. Am Heart J. 2012 Jun;163(6):954-962.e1 - PubMed
  77. Eur Heart J. 2020 Jun 14;41(23):2180-2182 - PubMed
  78. Comput Biol Med. 2012 Mar;42(3):347-52 - PubMed
  79. Am J Physiol Heart Circ Physiol. 2010 May;298(5):H1406-14 - PubMed
  80. J Am Coll Cardiol. 2008 Mar 4;51(9):920-9 - PubMed
  81. Med Biol Eng Comput. 1998 Jan;36(1):27-34 - PubMed
  82. Circulation. 2001 Apr 24;103(16):2072-7 - PubMed
  83. Ann Noninvasive Electrocardiol. 2010 Apr;15(2):165-74 - PubMed
  84. Circulation. 2007 Nov 20;116(21):2366-75 - PubMed
  85. Lancet. 1998 Feb 14;351(9101):478-84 - PubMed
  86. Nat Rev Cardiol. 2014 Jun;11(6):346-53 - PubMed
  87. Circulation. 1991 Aug;84(2):503-11 - PubMed
  88. Lancet. 1996 May 11;347(9011):1312-4 - PubMed
  89. Europace. 2001 Jan;3(1):39-45 - PubMed
  90. Schizophr Res. 2007 Sep;95(1-3):115-23 - PubMed
  91. J Am Coll Cardiol. 1997 Mar 1;29(3):568-75 - PubMed
  92. Am Heart J. 1985 May;109(5 Pt 1):937-48 - PubMed
  93. Med Biol Eng Comput. 1998 Jan;36(1):35-42 - PubMed
  94. Circulation. 1985 Sep;72(3):585-95 - PubMed
  95. J Am Coll Cardiol. 2018 Nov 27;72(21):2609-2621 - PubMed
  96. Circulation. 2015 Jun 23;131(25):2185-93 - PubMed
  97. Circulation. 1997 Sep 2;96(5):1557-65 - PubMed
  98. J Am Coll Cardiol. 2016 Jul 12;68(2):149-58 - PubMed
  99. Med Biol Eng Comput. 2019 Aug;57(8):1753-1762 - PubMed
  100. J Clin Med. 2019 Apr 11;8(4): - PubMed
  101. Circulation. 2005 Oct 25;112(17):2602-10 - PubMed
  102. Nat Rev Cardiol. 2017 Jan;14(1):30-38 - PubMed
  103. J Physiol. 2019 May;597(10):2599-2601 - PubMed
  104. Physiol Meas. 2015 Apr;36(4):741-53 - PubMed
  105. J Appl Physiol (1985). 2012 Dec 15;113(12):1810-20 - PubMed
  106. Am J Physiol Heart Circ Physiol. 2008 Sep;295(3):H962-H968 - PubMed
  107. J Hypertens. 2017 Aug;35(8):1666-1675 - PubMed
  108. J Appl Physiol (1985). 2018 Mar 1;124(3):791-804 - PubMed
  109. Circ Res. 1987 Jun;60(6):942-51 - PubMed
  110. J Electrocardiol. 2010 Nov-Dec;43(6):649-53 - PubMed
  111. Am J Physiol Heart Circ Physiol. 2000 Nov;279(5):H2558-67 - PubMed
  112. J Am Coll Cardiol. 2012 Dec 18;60(24):2515-24 - PubMed
  113. Clin Sci (Lond). 2011 Sep;121(6):279-84 - PubMed
  114. IEEE Trans Biomed Eng. 2004 Sep;51(9):1511-20 - PubMed
  115. Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):719-27 - PubMed
  116. Clin Sci (Lond). 2002 Jul;103(1):81-8 - PubMed
  117. Heart Rhythm. 2014 Mar;11(3):360-6 - PubMed
  118. Heart Rhythm. 2011 Aug;8(8):1237-42 - PubMed
  119. Circ Res. 1991 May;68(5):1471-81 - PubMed
  120. Am Heart J. 1995 Sep;130(3 Pt 1):473-80 - PubMed
  121. Physiol Meas. 2011 Sep;32(9):1425-37 - PubMed
  122. Psychiatry Res. 2000 Apr 10;93(3):225-35 - PubMed
  123. Heart Rhythm. 2016 Jan;13(1):62-9 - PubMed
  124. J Hypertens. 2004 Jul;22(7):1371-80 - PubMed
  125. Med Biol Eng Comput. 2019 Feb;57(2):389-400 - PubMed
  126. Circulation. 2004 Apr 20;109(15):1826-33 - PubMed
  127. Heart Rhythm. 2008 Feb;5(2):208-14 - PubMed
  128. Cardiovasc Res. 1970 Apr;4(2):160-7 - PubMed
  129. J Physiol. 2016 Jul 15;594(14):3911-54 - PubMed
  130. J Auton Nerv Syst. 1984 Dec;11(4):349-66 - PubMed
  131. Am Heart J. 1985 Feb;109(2):399-411 - PubMed
  132. Circulation. 1992 Jan;85(1 Suppl):I77-91 - PubMed
  133. J Electrocardiol. 1971;4(1):34-43 - PubMed
  134. Heart Rhythm. 2014 Jul;11(7):1131-8 - PubMed
  135. Am J Physiol. 1981 Oct;241(4):H620-9 - PubMed
  136. Circulation. 1984 Apr;69(4):790-800 - PubMed
  137. Cardiovasc Res. 2015 Oct 1;108(1):31-8 - PubMed
  138. Am J Physiol. 1969 Sep;217(3):703-9 - PubMed
  139. Heart Rhythm. 2011 Oct;8(10):1584-90 - PubMed
  140. Am J Physiol Heart Circ Physiol. 2005 Apr;288(4):H1777-85 - PubMed
  141. N Engl J Med. 1971 Oct 14;285(16):877-83 - PubMed
  142. Eur J Heart Fail. 2008 Sep;10(9):884-91 - PubMed
  143. Physiol Meas. 2007 Jun;28(6):731-44 - PubMed
  144. J Cardiovasc Pharmacol. 1981 Nov-Dec;3(6):1251-9 - PubMed
  145. Circulation. 1973 Feb;47(2):291-8 - PubMed
  146. Circ Res. 1969 Jan;24(1):109-21 - PubMed
  147. J Cardiovasc Electrophysiol. 1998 Sep;9(9):899-908 - PubMed
  148. Am J Physiol Heart Circ Physiol. 2008 Sep;295(3):H923-H925 - PubMed
  149. Clin Sci (Lond). 2001 Oct;101(4):429-38 - PubMed
  150. Circulation. 1994 Oct;90(4):1826-31 - PubMed
  151. Integr Physiol Behav Sci. 1997 Jul-Sep;32(3):220-7 - PubMed
  152. Clin Auton Res. 2006 Aug;16(4):256-61 - PubMed
  153. J Physiol. 2019 May;597(10):2603-2604 - PubMed

Publication Types