

Parameters based on heart rate variability alone or on both heart rate and blood pressure variability (baroreflex sensitivity) are becoming increasingly clinical relevant. Nevertheless a complete insight in physiological mechanisms underlying these parameters is still lacking. A computer model may help to fill up some of the gaps. We present a model which consists of a simple beat-to-beat hemodynamic part (Starling heart and Windkessel) linked to a detailed continuous modelled neural control part. The intermediate between continuous and beat-to-beat part is an integral pulse frequency modulator (IPFM) acting as cardiac pacemaker. Input for the IPFM is a “sympathovagal” balance signal, with different dynamics for sympathetic and vagal branches. Low-frequency variability is supposed to arise from resonance of existing noise, while high-frequency variability (respiration) is assumed to enter the closed loop at the hemodynamic (blood pressure) site. Results of three studies have been used for validation: (1) spontaneous variability in heart rate and blood pressure (baroreflex transfer functions), (2) vagal blockade with atropine, (3) a modified Valsalva manoeuvre performed in normal and quadriplegic man. Steady state as well as dynamic properties of the model reasonably well fitted to these experimental data.