Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health Risk

Heart  rate  variability,  the  change  in the  time  intervals  between  adjacent heartbeats, is an emergent property of interdependent   regulatory   systems that  operates  on  different  time  scales to  adapt  to  environmental  and  psychological   challenges.   This   article briefly  reviews  neural  regulation  of the  heart  and  offers  some  new  perspectives on mechanisms underlying the very low frequency  rhythm  of heart rate variability. Interpretation of heart  rate  variability  rhythms  in  the context of health risk and physiological  and  psychological  self-regulatory capacity assessment is discussed. The cardiovascular  regulatory  centers  in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic  cardiac  nervous  system  and the heart-brain connection pathways, through  which  afferent  information can influence activity in the subcortical,  frontocortical,  and  motor  cortex areas. In addition, the use of real-time  HRV  feedback  to  increase  self-regulatory  capacity  is  reviewed.  We conclude that the heart’s rhythms are characterized by both complexity and stability  over  longer  time  scales  that reflect both physiological and psycho-logical functional status of these internal self-regulatory systems.

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