LAUSR

BackgroundAlthough the absolute values of pulmonary ventilation and cardiac output are similar, the designs of the respiratory and cardiovascular systems imply major differences in flow patterns, airflow being intermittent by comparison to the quasi-continuous pulmonary blood flow.PurposeWe hypothesized that respiratory sinus arrhythmia (RSA, difference in heart rate (fH) between inspiration and expiration, as percent of mean fH) ameliorates the inevitable differences between air- and blood-flow patterns. Specifically, we hypothesized RSA to correlate more closely to the ratio between fH and breathing frequency (fR) (fH/fR “breathing-specific heart rate”, a proxy for cardio-respiratory coupling) than to either fH or fR alone. Hence, we designed protocols to change independently fH or fR.MethodsWe measured RSA breath-by-breath in 145 young men and women during spontaneous breathing, breathing under cues at different fR (to modify the denominator of fH/fR) and immediately post-exercise while breathing freely or by keeping fR as at rest (to modify the nominator of fH/fR).ResultsRSA had no significant correlation with fH, and a better correlation with fH/fR (r2 = 0.92) than with fR alone (r2 = 0.75); the variance of the Y values of the fH/fR-RSA correlation was ~ half that of the fR/RSA correlation (P < 0.002).ConclusionsWe propose that the fH/fR-RSA relationship reflects a central process that ameliorates gas exchange against the difference between air- and blood-flow patterns. The neurological mechanisms are still conjectural. Measurements of RSA could offer a glimpse of the degree of cardio-respiratory central compensation in face of the inequality between blood flow and airflow.