EPISODE 23 – THIS WEEK IN HEART RATE VARIABILITY

Episode Title:
HRV Across Cardiovascular Disease, Stress, Cognition, Development, and Social Connection

Episode Summary:
In Episode 23 of the Heart Rate Variability Podcast, we take an in-depth look at six recent peer-reviewed studies that collectively illustrate how heart rate variability (HRV) is being used across medicine, neuroscience, psychology, and emerging technologies. From cardiovascular disease prognosis to chronic stress burden, from Alzheimer’s-related fall risk to virtual reality–based physiological synchrony, this episode highlights HRV as a transdiagnostic marker of autonomic flexibility, resilience, and vulnerability.

Rather than treating HRV as a single “good or bad” number, this episode emphasizes context, interpretation, and clinical nuance. HRV is explored as a window into nervous system regulation across the lifespan and across settings, with implications for clinicians, researchers, and individuals alike.

Medical Disclaimer:
This podcast is for educational and informational purposes only and does not constitute medical advice. The information presented is not intended to diagnose, treat, cure, or prevent any disease. Always consult a qualified healthcare professional before making changes to medical care, mental health treatment, or lifestyle practices.

STUDIES DISCUSSED IN THIS EPISODE

Cardiovascular Disease and HRV (Review Article)

Full Title:
Heart rate variability in cardiovascular disease diagnosis, prognosis, and management

Authors:
Brian Xiangzhi Wang, MD
Ella Brennand, MD
Pierre Le Page, MD
Andrew R. J. Mitchell, MD, PhD

Affiliations:
Department of Medicine, Jersey General Hospital, St. Helier, Jersey
Department of Medicine, John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom

Journal:
Frontiers in Cardiovascular Medicine
Section: Cardiac Rhythmology
Publication Date: January 26, 2026

Key Points:
• Reduced HRV is associated with arrhythmias, heart failure, ischemic heart disease, and post–myocardial infarction outcomes
• HRV may reveal early autonomic dysfunction before overt clinical symptoms
• Prognostic value of HRV remains debated due to mixed findings and methodological variability
• HRV shows promise for tracking recovery and monitoring comorbid conditions such as depression
• Wearable devices and machine learning may expand HRV’s clinical utility
• Major challenges include a lack of standardization and limited incremental predictive value over established risk factors

Article Link:
https://doi.org/10.3389/fcvm.2025.1680783

Allostatic Load, HRV, and Brain Networks

Full Title:
Linking allostatic load, heart rate variability and brain functional networks and structures in healthy men

Authors:
Juan M. Solano-Atehortua
Gabriel Castrillón
Jazmin X. Suarez-Revelo
Juan D. Sánchez-López
Daniel A. Vargas-Tejada
Valentina Hawkins-Caicedo
Juan C. Calderón
Jaime Gallo-Villegas
Yedselt V. Ospina-Serrano
Juan D. Caicedo-Jaramillo
Ana L. Miranda-Angulo

Journal:
Psychoneuroendocrinology
Publication Year: 2026

Key Points:
• Higher allostatic load is associated with lower HRV in healthy men
• A seven-biomarker allostatic load index (ALI-7) was positively associated with the LF/HF ratio
• Findings suggest increased sympathetic dominance with greater cumulative stress burden
• Brain functional connectivity and structure did not significantly moderate the HRV–allostatic load relationship
• ALI-7 may serve as an early marker of morbidity and mortality risk

Article Link:
https://doi.org/10.1016/j.psyneuen.2026.107759

HRV and Falls in Alzheimer’s Disease

Full Title:
Assessment of heart rate variability and occurrence of falls in Alzheimer’s disease: an exploratory study

Authors:
Evelize Antunes Rodrigues
Aline Roberta Danaga
Etiene Farah Teixeira de Carvalho
Carlos Alberto Santos Filho
José Burgos Ponce
Alessandro Ferrari Jacinto

Journal:
Arquivos de Neuro-Psiquiatria
Publication Date: January 25, 2026

Key Points:
• Older adults with Alzheimer’s disease showed greater autonomic dysfunction than controls
• Reduced parasympathetic activity and increased sympathetic dominance were observed
• Autonomic impairment was more pronounced during orthostatic challenge
• Alzheimer’s group experienced a higher incidence of falls
• Fall history was associated with HRV components

Article Link:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12832160/

HRV Synchrony in Virtual Reality Collaboration

Full Title:
Remote collaboration in virtual reality induces physiological synchrony comparable to face-to-face interaction

Authors:
Stephan Streuber
Sarah Rogula
Maria Alejandra Quirós-Ramírez
Jens Pruessner

Journal:
Scientific Reports (Nature Portfolio)
Publication Date: January 27, 2026

Key Points:
• Physiological synchrony reflects implicit social and emotional alignment
• HRV synchrony was strong in face-to-face and immersive VR collaboration
• HRV synchrony was significantly weaker during video conferencing
• VR may support autonomic co-regulation and social cohesion

Article Link:
https://www.nature.com/articles/s41598-026-35955-y

HRV and Attention in Children with ADHD

Full Title:
Heart Rate Variability and MOXO d-CPT Relationship in Children with Attention Deficit Hyperactivity Disorder

Authors:
Sultan Tarlacı
Yaren Kaya Topal

Journal:
Applied Psychophysiology and Biofeedback
Publication Date: January 27, 2026

Key Points:
• Children with poorer MOXO performance showed higher sympathetic activation
• VLF power and SNS Index were the most robust HRV markers
• Traditional HRV metrics (SDNN, RMSSD) showed only modest, non-significant trends
• HRV may be useful for monitoring regulation and treatment response rather than diagnosis

Article Link:
https://link.springer.com/article/10.1007/s10484-026-09766-w

HRV Dynamics in Subjective Cognitive Decline

Full Title:
Cognitive changes and emotional heart rate variability dynamics in subjective cognitive decline: An exploratory longitudinal neuropsychophysiological study

Authors:
Giuseppina Elena Cipriani
Francesca Borghesi
Pietro Cipresso
Nicola Canessa
Sara Molfese
Cristiano Manco
Alice Chirico
Gloria Simoncini
Matteo Anselmino
Martina Amanzio

Journal:
Acta Psychologica
Publication Year: 2026

Key Points:
• HRV responses during emotional stimulation correlated with cognitive trajectories
• Changes in parasympathetic indices were associated with changes in cognition
• Findings align with neurovisceral integration models
• HRV may serve as an early psychophysiological marker of cognitive vulnerability

Article Link:
https://doi.org/10.1016/j.actpsy.2026.106308

This episode is sponsored by Optimal HRV.

Optimal HRV provides trauma-informed, research-based heart rate variability biofeedback tools for clinicians, researchers, and individuals. The platform integrates HRV assessment, guided breathing, biofeedback training, and professional education to support nervous system regulation and resilience.

Learn more at:
https://optimalhrv.com

Upcoming Event:
Biofeedback Federation of Europe (BFE) – 24th Annual Meeting

Dates:
March 23–28, 2026

Location:
Szczecin, Poland

Highlights:
• Six days of immersive workshops and scientific programming
• International faculty and networking opportunities
• Featured presenter: Dr. Inna Khazan
• Hands-on training in HRV biofeedback, neurofeedback, and applied psychophysiology

Registration:
https://bfemeeting.org