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September 12, 2026Journal of the American College of Cardiology567 citationsOpen Access

Assessment of Autonomic Function in Cardiovascular Disease

MLMarc K. LahiriPKPrince J. KannankerilJGJeffrey J. Goldberger

Key Result

Markers of autonomic activity, such as heart rate variability and recovery, provide related but non-redundant prognostic information for identifying patients at risk for sudden death.

Key Points

  • To examine markers of autonomic nervous system function and evaluate their prognostic utility in identifying sudden death risk among individuals with structural cardiovascular disease.
  • Reviewed physiological mechanisms of sympathetic and parasympathetic regulation affecting sinus node activity.
  • Evaluated clinical utility of resting heart rate, heart rate variability, and post-exercise heart rate recovery as prognostic markers.
  • Resting heart rate reflects net tonic autonomic effects on the sinus node and provides baseline prognostic risk stratification.
  • Heart rate variability assesses dynamic autonomic modulation and delivers complementary prognostic information that often exceeds resting heart rate alone.
  • Impaired heart rate recovery immediately following exercise reflects abnormal autonomic reactivity during a high-risk window for sudden cardiac death.

PICO

P
Population
Cardiovascular Disease
E
Exposure / Comparator
Autonomic function markers
O
Primary Outcome
Sudden death

Abstract

Certain abnormalities of autonomic function in the setting of structural cardiovascular disease have been associated with an adverse prognosis. Various markers of autonomic activity have received increased attention as methods for identifying patients at risk for sudden death. Both the sympathetic and the parasympathetic limbs can be characterized by tonic levels of activity, which are modulated by, and respond reflexively to, physiological changes. Heart rate provides an index of the net effects of autonomic tone on the sinus node, and carries prognostic significance. Heart rate variability, though related to heart rate, assesses modulation of autonomic control of heart rate and carries additional prognostic information, which in some cases is more powerful than heart rate alone. Heart rate recovery after exercise represents the changes in autonomic tone that occur immediately after cessation of exercise. This index has also been shown to have prognostic significance. Autonomic evaluation during exercise and recovery may be important prognostically, because these are high-risk periods for sudden death, and the autonomic changes that occur with exercise could modulate this high risk. These markers provide related, but not redundant information about different aspects of autonomic effects on the sinus node.

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Cite This Study

Lahiri et al. (2008) conducted a review in Cardiovascular Disease. Autonomic function markers was evaluated on Sudden death. Markers of autonomic activity, such as heart rate variability and recovery, provide related but non-redundant prognostic information for identifying patients at risk for sudden death.

synapsesocial.com/papers/6aa518f48a556e17f23c061ahttps://doi.org/10.1016/j.jacc.2008.01.038
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Autonomic origin of heart rate fluctuations at the onset of muscular exercise1976 · 180 citations
  2. 2The normal range and determinants of the intrinsic heart rate in man1970 · 581 citations
  3. 3Sympathovagal balance: how should we measure it?1999 · 257 citations
  4. 4Heart rate and muscle sympathetic nerve variability during reflex changes of autonomic activity1990 · 344 citations
  5. 5Heritability of Heart Rate Variability1999 · 228 citations