Cardiorespiratory coupling improves cardiac pumping efficiency in heart failure
Journal:
arXiv
Published Date:
Jul 1, 2025
Abstract
Recent trials of a neuronal pacemaker have shown that cardiac pumping
efficiency increases when respiratory sinus arrhythmia (RSA) is artificially
restored in animal models of heart failure. This novel device sheds new light
on the functional role of RSA, which has long been debated, by allowing the
strength of cardiorespiratory coupling to be artificially varied. Here we show
that RSA minimizes the cardiac power dissipated within the cardiovascular
network. The cardiorespiratory system is found to exhibit mode-locked
synchronized regions within which viscoelastic dissipation is reduced relative
to the scenario where cardiorespiratory coupling is absent. We determine the
gain in cardiac output as the magnitude of RSA increases. We find that cardiac
pumping efficiency improves up and until the cardiac frequency, within each
breadth intake, is approximately 1.5 times greater than the cardiac frequency
in the expiratory phase, at which point it reaches a plateau. RSA was found to
be most effective at low cardiac frequencies, in good agreement with clinical
evidence. Simulation of the cardiac power saved under RSA is in good agreement
with the 17-20% increase in cardiac output observed in RSA-paced animal models.
