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Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity.

作者信息

Menuet Clément, Ben-Tal Alona, Linossier Ambre, Allen Andrew M, Machado Benedito H, Moraes Davi J A, Farmer David G S, Paterson David J, Mendelowitz David, Lakatta Edward G, Taylor Edwin W, Ackland Gareth L, Zucker Irving H, Fisher James P, Schwaber James S, Shanks Julia, Paton Julian F R, Buron Julie, Spyer K Michael, Shivkumar Kalyanam, Dutschmann Mathias, Joyner Michael J, Herring Neil, Grossman Paul, McAllen Robin M, Ramchandra Rohit, Yao Song T, Ritz Thomas, Gourine Alexander V

机构信息

INMED, INSERM, Aix-Marseille University, Marseille, France.

Insightful Modelling, Auckland, New Zealand.

出版信息

Nat Rev Cardiol. 2025 May 6. doi: 10.1038/s41569-025-01160-z.


DOI:10.1038/s41569-025-01160-z
PMID:40328963
Abstract

The variation of heart rate in phase with breathing, known as 'respiratory sinus arrhythmia' (RSA), is a physiological phenomenon present in all air-breathing vertebrates. RSA arises from the interaction of several physiological mechanisms but is primarily mediated by rhythmic changes in cardiac parasympathetic (vagal) activity, increasing heart rate during inspiration and decreasing heart rate during expiration. RSA amplitude is an indicator of autonomic and cardiac health; RSA is diminished or absent in common pathological conditions such as chronic heart failure and hypertension. In this Expert Recommendation, we argue that the term 'RSA', although historically important, is semantically inaccurate and carries misleading pathological connotations, contributing to misunderstanding and misinterpretation of the origin and the physiological importance of the phenomenon. We propose replacing 'RSA' with the term 'respiratory heart rate variability' (RespHRV), which avoids pathological connotations and emphasizes the specific respiratory contribution to heart rate variability. We clarify that RespHRV encompasses respiratory-related heart rate variations in both the low-frequency and high-frequency bands traditionally defined in heart rate variability analysis, and that its amplitude should not be misconstrued as a measure of vagal tone. Adopting the proposed term 'RespHRV' is expected to unify understanding and stimulate further experimental and clinical research into the physiological mechanisms and functional importance of this phenomenon.

摘要

相似文献

[1]
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[2]
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[8]
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引用本文的文献

[1]
Principal Connection Between Typical Heart Rate Variability Parameters as Revealed by a Comparative Analysis of Their Heart Rate and Age Dependence.

Entropy (Basel). 2025-7-25

[2]
Hypertension in 2025: are we ready for bold precision public health approaches worldwide?

Nat Rev Cardiol. 2025-9

[3]
Vagal impairment and cardiovascular risk in those with zero to low coronary artery calcification scores: the Multi-Ethnic Study of Atherosclerosis.

Am J Physiol Heart Circ Physiol. 2025-7-1

本文引用的文献

[1]
Firing properties of single axons with cardiac rhythmicity in the human cervical vagus nerve.

J Physiol. 2025-3

[2]
Top-down brain circuits for operant bradycardia.

Science. 2024-6-21

[3]
How to account for respiration in respiratory sinus arrhythmia: Publication standards for heart rate variability studies in Biological Psychology.

Biol Psychol. 2024-7

[4]
Blood pressure pulsations modulate central neuronal activity via mechanosensitive ion channels.

Science. 2024-2-2

[5]
Respiratory sinus arrhythmia (RSA), vagal tone and biobehavioral integration: Beyond parasympathetic function.

Biol Psychol. 2024-2

[6]
Putting back respiration into respiratory sinus arrhythmia or high-frequency heart rate variability: Implications for interpretation, respiratory rhythmicity, and health.

Biol Psychol. 2024-1

[7]
Bioelectronics for neurocardiology: diagnosis and therapeutics.

Eur Heart J. 2023-12-7

[8]
A Unifying Method to Study Respiratory Sinus Arrhythmia Dynamics Implemented in a New Toolbox.

eNeuro. 2023-10

[9]
Cardiac Vagal Nerve Activity Increases During Exercise to Enhance Coronary Blood Flow.

Circ Res. 2023-9-15

[10]
Immediate and sustained increases in the activity of vagal preganglionic neurons during exercise and after exercise training.

Cardiovasc Res. 2023-10-24

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