Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Assessment and Therapeutic Modulation of Heart Rate Variability: Potential Implications in Patients with COVID-19

Luiz G. Schnekenberg
,
Annahita Sedghi
ORCID logo ,
Daniela Schöne
,
Lars-Peder Pallesen
,
Jessica Barlinn
,
Felix Woitek
,
Axel Linke
,
Volker Puetz
,
Kristian Barlinn
,
Norman Mangner
,
Timo Siepmann
*
Version 1 : Received: 26 May 2023 / Approved: 31 May 2023 / Online: 31 May 2023 (12:55:32 CEST)

A peer-reviewed article of this Preprint also exists.

Schnekenberg, L.; Sedghi, A.; Schoene, D.; Pallesen, L.-P.; Barlinn, J.; Woitek, F.; Linke, A.; Puetz, V.; Barlinn, K.; Mangner, N.; Siepmann, T. Assessment and Therapeutic Modulation of Heart Rate Variability: Potential Implications in Patients with COVID-19. J. Cardiovasc. Dev. Dis. 2023, 10, 297. Schnekenberg, L.; Sedghi, A.; Schoene, D.; Pallesen, L.-P.; Barlinn, J.; Woitek, F.; Linke, A.; Puetz, V.; Barlinn, K.; Mangner, N.; Siepmann, T. Assessment and Therapeutic Modulation of Heart Rate Variability: Potential Implications in Patients with COVID-19. J. Cardiovasc. Dev. Dis. 2023, 10, 297.

Abstract

Cardiac damage has been attributed to SARS-Cov-2-related pathology contributing to increased risk of vascular events. Heart rate variability (HRV) is a parameter of functional neurocardiac integrity with low HRV constituting an independent predictor of cardiovascular mortality. Whether structural cardiac damage translates into neurocardiac dysfunction in patients infected with SARS-CoV-2 remains poorly understood. Hypothesized mechanisms of possible neurocardiac dysfunction in COVID-19 comprise direct systemic neuroinvasion of autonomic control centers, ascending virus propagation along cranial nerves and cardiac autonomic neuropathy. While the relationship between the autonomic nervous system and the cytokine cascade in general has been studied extensively, the interplay between the inflammatory response caused by SARS-CoV-2 and autonomic cardiovascular regulation remains largely unclear. We reviewed the current literature on the potential diagnostic and prognostic value of autonomic neurocardiac function assessment via analysis of HRV in patients with COVID-19. Furthermore, we discuss potential therapeutic targets of modulating neurocardiac function in this high-risk population.

Keywords

SARS-CoV-2; COVID-19; heart rate variability; cardiac; cardiovascular; parasympathetic; sympathetic; autonomic

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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