Cardiorespiratory Coupling-novel Insights for Integrative Biomedicine

Integrative physiology is gaining increased attention in recent years. Novel findings in the area of molecular and systemic cardiopulmonary interaction overgrow the classical opinion that the adoption and transport of oxygen and elimination of carbon dioxide are their only functions. Mechanical, molecular, endocrine and neural subsystems of the autonomic nervous system are integrative scales of these two mutually dependent organs. They, in anintegrative way, provide a wider range of adaptation of the organism to the growing requirements of the environment.

Different computational analysis of the interdependence of cardiac and respiratory rates quantitatively describe the nature of integrative central and peripheral autonomic mechanisms, both in linear and nonlinear domain. Linear methods provided the first insights on quantitative parameters of cardiorespiratory mechanisms active in stationary states, while nonlinear methods deal with a much wider range of their nonstationary activity, indirectly pointing also on the causal relationship of the closed loop heart-lungs axes. Dynamic and complex interactions between the cardiac and respiratory systems, as important homeostatic control mechanisms, are becoming increasingly important for the investigation of physiological as well as pathophysiological states. Novel concepts and approaches based on linear and nonlinear dynamics, and information theory provide new insights into the complexity of physiological coupled structures and functions in health and disease states, bridging the genetic and sub-cellular level with intercellular and interorgan interactions and communications among the various integrated sub-systems. Research of molecular and endocrine cardiorespiratory integration is expanding and pointing on pituitary and adrenal mechanisms as necessary integrators. Molecular organ-to-organ communication of cardiovascular system and respiratory system is a new line for translational medicine and novel promising therapeutic interventions in integrative pathophysiological problems such as pulmonary arterial hypertension.

Joining our multidisciplinary approaches and visions into a comprehensive image of cardiorespiratory interactions will make a step forward to our knowledge of integrative biomedicine and a strong impact on the future therapeutic development in the area of cardiorespiratory medicine.