Aging and cardiac autonomic control in chronic heart failure: Methods and clinical implications

A large body of evidence has been provided that cardiac autonomic control is deranged in heart failure. It is also commonly accepted that aging is characterized by several molecular and structural changes in organs and tissues, and per se affects cardiac autonomic control. Hence, as far as we are concerned with heart failure in the elderly, both cardiac diseases and age are likely to contribute to the autonomic dysfunction of these patients. In the first part a brief review to the methods currently used to assess the autonomic control of the cardiovascular function in human subjects is reported. Then, major findings on the relationship between aging and cardiac autonomic indexes in normal subjects are presented. In the third part, main concept and experimental observations on autonomic dysfunction in heart failure are reviewed. Finally, some basic considerations on the relationship between aging, cardiac autonomic function and heart failure are introduced. 1. A brief review to the methods currently used to assess the autonomic control of the cardiovascular function in human subjects is reported. 2. The relationship between aging and cardiac autonomic indexes in normal subjects are presented. 3. Main concept and experimental observations on autonomic dysfunction in heart failure are reviewed.