Clément Menuet,Alona Ben-Tal,Ambre Linossier,Andrew M Allen,Benedito H Machado,Davi J A Moraes,David G S Farmer,David J Paterson,David Mendelowitz,Edward G Lakatta,Edwin W Taylor,Gareth L Ackland,Irving H Zucker,James P Fisher,James S Schwaber,Julia Shanks,Julian F R Paton,Julie Buron,K Michael Spyer,Kalyanam Shivkumar,Mathias Dutschmann,Michael J Joyner,Neil Herring,Paul Grossman,Robin M McAllen,Rohit Ramchandra,Song T Yao,Thomas Ritz,Alexander V Gourine
{"title":"Redefining respiratory sinus arrhythmia as respiratory heart rate variability: an international Expert Recommendation for terminological clarity.","authors":"Clément Menuet,Alona Ben-Tal,Ambre Linossier,Andrew M Allen,Benedito H Machado,Davi J A Moraes,David G S Farmer,David J Paterson,David Mendelowitz,Edward G Lakatta,Edwin W Taylor,Gareth L Ackland,Irving H Zucker,James P Fisher,James S Schwaber,Julia Shanks,Julian F R Paton,Julie Buron,K Michael Spyer,Kalyanam Shivkumar,Mathias Dutschmann,Michael J Joyner,Neil Herring,Paul Grossman,Robin M McAllen,Rohit Ramchandra,Song T Yao,Thomas Ritz,Alexander V Gourine","doi":"10.1038/s41569-025-01160-z","DOIUrl":null,"url":null,"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.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"51 1","pages":""},"PeriodicalIF":41.7000,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature Reviews Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41569-025-01160-z","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍:
Nature Reviews Cardiology aims to be the go-to source for reviews and commentaries in the scientific and clinical communities it serves. Focused on providing authoritative and accessible articles enriched with clear figures and tables, the journal strives to offer unparalleled service to authors, referees, and readers, maximizing the usefulness and impact of each publication. It covers a broad range of content types, including Research Highlights, Comments, News & Views, Reviews, Consensus Statements, and Perspectives, catering to practising cardiologists and cardiovascular research scientists. Authored by renowned clinicians, academics, and researchers, the content targets readers in the biological and medical sciences, ensuring accessibility across various disciplines. In-depth Reviews offer up-to-date information, while Consensus Statements provide evidence-based recommendations. Perspectives and News & Views present topical discussions and opinions, and the Research Highlights section filters primary research from cardiovascular and general medical journals. As part of the Nature Reviews portfolio, Nature Reviews Cardiology maintains high standards and a wide reach.