Dubinkina ES, Kiselev AR. Cardiorespiratory coordination: Historical development of analysis methods, current state, and future research prospects. World J Cardiol 2026; 18(9): 125211 [DOI: 10.4330/wjc.125211]
Corresponding Author of This Article
Anton R Kiselev, Head, Professor, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per. 10, Moscow 101990, Moscow, Russia. antonkis@list.ru
Research Domain of This Article
Cardiac & Cardiovascular Systems
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review-article
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Dubinkina ES, Kiselev AR. Cardiorespiratory coordination: Historical development of analysis methods, current state, and future research prospects. World J Cardiol 2026; 18(9): 125211 [DOI: 10.4330/wjc.125211]
World J Cardiol. Sep 26, 2026; 18(9): 125211 Published online Sep 26, 2026. doi: 10.4330/wjc.125211
Cardiorespiratory coordination: Historical development of analysis methods, current state, and future research prospects
Elizaveta S Dubinkina, Anton R Kiselev
Elizaveta S Dubinkina, Anton R Kiselev, Department of Dynamic Modeling and Biomedical Engineering, Institute of Physics, Saratov State University, Saratov 410012, Saratovskaya Oblast’, Russia
Elizaveta S Dubinkina, Department of Fundamentals of Medicine and Medical Technologies, Faculty of Fundamental Medicine and Medical Technologies, Saratov State University, Saratov 410012, Saratovskaya Oblast’, Russia
Anton R Kiselev, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Moscow, Russia
Co-first authors: Elizaveta S Dubinkina and Anton R Kiselev.
Author contributions: Kiselev AR designed the research study; Dubinkina ES performed the research; both authors made crucial and indispensable contributions to the completion of the project and are thus qualified as the co-first authors of the paper.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Russian Science Foundation, No. 25-44-10019.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Anton R Kiselev, Head, Professor, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per. 10, Moscow 101990, Moscow, Russia. antonkis@list.ru
Received: July 3, 2026 Revised: August 17, 2026 Accepted: August 28, 2026 Published online: September 26, 2026 Processing time: 80 Days and 10.4 Hours
Abstract
Cardiorespiratory coordination (CRC) is defined as a distinct form of cardiorespiratory interaction arising from the reciprocal influence exerted by the cardiac and respiratory cycles on the timing of their respective onsets. In contrast to respiratory sinus arrhythmia and cardiorespiratory phase synchronization, CRC obviates the need for phase estimation, exhibits robustness to irregular cardiac rhythms, and enables the directionality of coupling to be assessed. This narrative review presents the history of the development of CRC analysis methods (1966-2024), from histogram analysis to the automated coordigram method. Notably, no direct investigations of CRC have been conducted to date in major cardiovascular pathologies, including arterial hypertension, myocardial infarction, and chronic ischemic heart disease, nor in prevalent respiratory disorders such as chronic obstructive pulmonary disease and bronchial asthma. Drawing on distinct pathophysiological mechanisms, we advance competing hypotheses regarding the expected direction of CRC alterations in each of these conditions. We conclude that further experiments in patients with these conditions are needed to assess the diagnostic potential of CRC.
Core Tip: This review systematizes the development of cardiorespiratory coordination (CRC) analysis methods from 1966 to 2024, highlighting its advantages over respiratory sinus arrhythmia and cardiorespiratory phase synchronization. Unlike these methods, CRC does not require phase detection, is robust to irregular rhythms, and enables directionality assessment. The review identifies a critical gap—no direct CRC studies in arterial hypertension, myocardial infarction, chronic ischemic heart disease, chronic obstructive pulmonary disease, or bronchial asthma—and puts forward competing hypotheses grounded in pathophysiological mechanisms. It ultimately advocates for experimental studies to explore CRC's diagnostic potential in these conditions.
