Mayo Clinic, Rochester, Minnesota, USA.
William Harvey Research Institute, NIHR Barts Biomedical Centre, Queen Mary University, London, UK.
Compr Physiol. 2023 Mar 30;13(2):4493-4511. doi: 10.1002/cphy.c210037.
Autonomic neural control of the cardiovascular system is formed of complex and dynamic processes able to adjust rapidly to mitigate perturbations in hemodynamics and maintain homeostasis. Alterations in autonomic control feature in the development or progression of a multitude of diseases with wide-ranging physiological implications given the neural system's responsibility for controlling inotropy, chronotropy, lusitropy, and dromotropy. Imbalances in sympathetic and parasympathetic neural control are also implicated in the development of arrhythmia in several cardiovascular conditions sparking interest in autonomic modulation as a form of treatment. A number of measures of autonomic function have shown prognostic significance in health and in pathological states and have undergone varying degrees of refinement, yet adoption into clinical practice remains extremely limited. The focus of this contemporary narrative review is to summarize the anatomy, physiology, and pathophysiology of the cardiovascular autonomic nervous system and describe the merits and shortfalls of testing modalities available. © 2023 American Physiological Society. Compr Physiol 13:4493-4511, 2023.
自主神经系统对心血管系统的控制是由复杂而动态的过程形成的，能够快速调整以减轻血液动力学的干扰，维持体内平衡。自主控制的改变是许多疾病发展或进展的特征，鉴于神经系统负责控制心肌收缩力、心率、舒张功能和传导速度，其具有广泛的生理意义。交感神经和副交感神经控制的失衡也与几种心血管疾病中心律失常的发生有关，这引发了人们对自主调节作为一种治疗形式的兴趣。许多自主功能的测量方法在健康和病理状态下都显示出了预后意义，并经历了不同程度的改进，但在临床实践中的应用仍然非常有限。本当代叙述性综述的重点是总结心血管自主神经系统的解剖、生理和病理生理学，并描述现有测试方式的优缺点。© 2023 美国生理学会。《综合生理学》13:4493-4511, 2023。
