Assessment of cardiac autonomic function: from bench to bedside

Purpose of review Cardiac autonomic dysfunction plays a crucial role in the pathogenesis of common cardiovascular diseases. The review discusses current and emerging techniques in the evaluation of cardiac autonomic tone. Recent findings Assessment techniques include invasive nerve recordings, neurochemical staining, serum biomarkers, advanced imaging, and autonomic reflex testing. Noninvasive modalities such as heart rate variability and skin sympathetic nerve activity have improved clinical feasibility. Novel radiotracers and serum-based assays are emerging to map neurotransmitter dynamics and receptor activity with greater precision. Summary No single method captures the full spectrum of autonomic function. A multimodal approach, integrating structural, functional, and molecular tools, offers a more comprehensive evaluation. Future strategies combining imaging, transcriptomics, and biomarkers may enable earlier detection and guide personalized neuromodulation therapies in cardiovascular care.