autonomic nervous system interaction with the cardiovascular.pdfVIP

Autonomic Nervous System Interaction With the Cardiovascular System During Exercise James V. Freeman, Frederick E. Dewey, David M. Hadley, Jonathan Myers, and Victor F. Froelicher mounting evidence that parameters thought to There is considerable recent evidence that param- reflect the complex interplay between the ANS eters thought to reflect the complex interaction and the CVS during exercise testing can provide between the autonomic nervous system and the cardiovascular system during exercise testing can significant prognostic information. We will provide significant prognostic information. Specific present a basic physiological understanding of variables of great importance include heart rate the ANS, as well as the measurements that have (HR) response to exercise (reserve), HR recovery been used to assess ANS interaction with the after exercise, and multiple components of HR CVS. Specifically, we will discuss heart rate (HR) variability both at rest and with exercise. Poor HR response to exercise (reserve), HR recovery response to exercise has been strongly associated (HRR) after exercise, and multiple components with sudden cardiac death and HR recovery from a of HR variability (HRV) both at rest and with standard exercise test has been shown to be exercise. We will then review the strong evi- predictive of mortality. In addition, there are limited dence that has emerged over the last decade, studies evaluating the components of HR variability linking poor HR response to exercise w