CENTRAL ORIGIN OF DECREASED HEART-RATE-VARIABILITY IN PATIENTS WITH CARDIOVASCULAR-DISEASES

Sympathetic activity influences the total power of the heart rate vari ability spectrum. Decreased heart rate variability and increased sympa thetic tone have been related to poor prognosis and an increased risk of sudden cardiac death in patients with myocardial infarction, conges tive heart failure or hypertension. On the basis of recent experimenta l data, I propose that these disease states are associated with altere d spectral characteristics of the central sympathetic activity generat ed within rostral ventrolateral medulla neurones, which subsequently l eads to decreased heart rate variability and increased systemic sympat hetic tone.