Heart Rate Variability as an Early Window into Autonomic Dysregulation Before Disease

Heart rate variability (HRV) is more than a record of heartbeats; it is a non-invasive index of cardiac autonomic function, reflecting the heart’s response to autonomic input. The millisecond-level fluctuations between beats reflect the heart’s response to sympathetic and parasympathetic modulation, and, in particular, vagal regulation of the heart, as the body adapts moment to moment to its environment. HRV therefore offers an accessible, if indirect, window into cardiac autonomic regulation in everyday life, as well as a marker of both the dysregulation associated with disease, and the impact of therapeutic interventions.Growing evidence suggests that early autonomic dysregulation can be detected well before disease becomes clinically apparent. Chronic declines in HRV, blunted night-time vagal recovery, and reduced autonomic flexibility may represent some of the earliest signs that allostatic management is breaking down, for example, shifts in sympathetic–parasympathetic balance preceding migraine, deterioration of sleep-related autonomic patterns, or loss of autonomic adaptability under sustained cognitive or physical load. Understanding the mechanisms behind these signals, from brainstem, hypothalamic, and limbic control of cardiovascular function to vagal and baroreflex regulation, is central to interpreting HRV as a marker of early disease risk.Continuous, non-invasive measurement using wearable devices, advances in sensing and micro-electro-mechanical systems, and computational analysis now make it possible to track these autonomic dynamics in real-world conditions.This Research Topic focuses on what HRV reveals about autonomic function and its early dysregulation in the pre-disease stage. We welcome studies that use wearable, sensing, and AI-based methods in service of autonomic insight, rather than as an end in themselves, and that link HRV patterns to underlying autonomic mechanisms or to translational and clinical regulation of the autonomic system.To preserve the section’s focus, submissions should demonstrate genuine autonomic-mechanistic relevance. Pure device-validation, sports-performance, and general wellness or stress studies without autonomic insight fall outside the scope. Where animal or AI-based approaches are included, they should be tied explicitly to autonomic function.Topics of interest include, but are not limited to:HRV as an index of sympathetic–parasympathetic modulation and vagal regulation of cardiovascular functionCentral autonomic control (brainstem, hypothalamic, and limbic mechanisms) reflected in HRVEarly autonomic dysregulation in the pre-disease stage and its mechanistic basisSleep-related autonomic dynamics and night-time vagal recoveryAutonomic adaptation and loss of flexibility under cognitive or physical stressTranslational and clinical applications of HRV-based autonomic assessmentWearable, sensing, and AI-based methods validated against established autonomic measures, including direct recordings of autonomic outflow where possibleAutonomic regulation and welfare in animal models Topic editors: Jean-Baptiste Guichard, Yrsa B Sverrisdottir, Charles H Tegeler, Shin-ichi Sekizawa, Hossam Abdelnaby Shaltout Source: https://www.frontiersin.org/research-topics/87012/heart-rate-variability-as-an-early-window-into-autonomic-dysregulation-before-disease