Neurocardiology: Major mechanisms and effects.

Neurocardiology is a broad interdisciplinary specialty investigating how the cardiovascular and nervous systems interact. In this brief introductory review, we describe several key aspects of this interaction with specific attention to cardiovascular effects. The review introduces basic anatomy and discusses physiological mechanisms and effects that play crucial roles in the interaction of the cardiovascular and nervous systems, namely: the cardiac neuraxis, the taxonomy of the nervous system, integration of sensory input in the brainstem, influences of the autonomic nervous system (ANS) on heart and vasculature, the neural pathways and functioning of the arterial baroreflex, receptors and ANS effects in the walls of blood vessels, receptors and ANS effects in excitable cells in the heart, ANS effects on heart rate and sympathovagal balance, endo-epicardial inhomogeneity, ANS effects with a balanced vagal and sympathetic stimulation, sympathovagal interaction, arterial baroreflex, baroreflex sensitivity and heart rate variability, arrhythmias and the arterial baroreflex, the cardiopulmonary baroreflex, the exercise pressor reflex, exercise-recovery hysteresis, mental stress, cardiac-cardiac reflexes, the cardiac sympathetic afferent reflex (CSAR), and neuromodulation.

Impact of QRS misclassifications on heart-rate-variability parameters (results from the CARLA cohort study).

Background: Heart rate variability (HRV), an important marker of autonomic nervous system activity, is usually determined from electrocardiogram (ECG) recordings corrected for extrasystoles and artifacts. Especially in large population-based studies, computer-based algorithms are used to determine RR intervals. The Modular ECG Analysis System MEANS is a widely used tool, especially in large studies.

Context-independent identification of myocardial ischemia in the prehospital ECG of chest pain patients.

Non-traumatic chest pain is a frequent reason for an urgent ambulance visit of a patient by the emergency medical services (EMS). Chest pain (or chest pain-equivalent symptoms) can be innocent, but it can also signal an acute form of severe pathology that may require prompt intervention. One of these pathologies is cardiac ischemia, resulting from a disbalance between blood supply and demand.

Post hoc labeling an acute ECG as ischemic or non-ischemic based on clinical data: A necessary challenge.

The ECG is crucial in the prehospital (and early inhospital) phase of patients with symptoms suggestive of myocardial ischemia. Therefore, new algorithms for ECG-based myocardial ischemia detection are continuously being researched. Development and validation of these algorithms require a database of acute ECGs (from the prehospital or emergency department setting) including a representative mix of cases (ischemia present) and controls (no ischemia present).