elPBN neurons regulate rVLM activity through elPBN-rVLM projections during activation of cardiac sympathetic afferent nerves

Guo, Zhi‐Ling; Longhurst, John C.; Tjen‐A‐Looi, Stephanie C.; Fu, Liang‐Wu

doi:10.1152/ajpregu.00127.2016

Cited by 4 publications

(2 citation statements)

References 47 publications

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“…Furthermore, the RVLM, along with the external lateral parabrachial nucleus of the pons, is involved in the CNS processing of excitatory cardiovascular reflexes resulting in cardiac sympathetic stimulation. 14,15 The brainstem is an essential regulator of cardiovascular responses to the interactive or exteroceptive environment, as well as vagal and sympathetic nerve activity. 16 Patients having brainstem lesions can present with autonomic dysfunction, ventricular arrhythmias, T wave inversion, bradyarrhythmias, myocardial infarction (MI), and sudden cardiac death.…”

Section: Specific Brain Regions and Cardiovascular Changesmentioning

confidence: 99%

Head Rules Over the Heart: Cardiac Manifestations of Cerebral Disorders

Hrishi

Lionel

Prathapadas

2019

Indian Journal of Critical Care Medicine

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The Brain-Heart interaction is becoming increasingly important as the underlying pathophysiological mechanisms become better understood. “Neurocardiology” is a new field which explores the pathophysiological interplay of the brain and cardiovascular systems. Brain-heart cross-talk presents as a result of direct stimulation of some areas of the brain, leading to a sympathetic or parasympathetic response or it may present as a result of a neuroendocrine response attributing to a clinical picture of a sympathetic storm. It manifests as cardiac rhythm disturbances, hemodynamic perturbations and in the worst scenarios as cardiac failure and death. Brain-Heart interaction (BHI) is most commonly encountered in traumatic brain injury and subarachnoid hemorrhage presenting as dramatic electrocardiographic changes, neurogenic stunned myocardium or even as ventricular fibrillation. A well-known example of BHI is the panic disorders and emotional stress resulting in Tako-tsubo syndrome giving rise to supraventricular and ventricular tachycardias and transient left ventricular dysfunction. In this review article, we will discuss cardiovascular changes caused due to the disorders of specific brain regions such as the insular cortex, brainstem, prefrontal cortex, hippocampus and the hypothalamus; neuro-cardiac reflexes namely the Cushing's reflex, the Trigemino-cardiac reflex and the Vagal reflex; and other pathological states such as neurogenic stunned myocardium /Takotsubo cardiomyopathy. There is a growing interest among intensivists and anesthesiologists in brain heart interactions as there are an increasing number of cases being reported and there is a need to address unanswered questions, such as the incidence of these interactions, the multifactorial pathogenesis, individual susceptibility, the role of medications, and optimal management. Key Messages BHI contribute in a significant way to the morbidity and mortality of neurological conditions such as traumatic brain injury, subarachnoid hemorrhage, cerebral infarction and status epilepticus. Constant vigilance and a high index of suspicion have to be exercised by clinicians to avoid misdiagnosis or delayed recognition. The entire clinical team involved in patient care should be aware of brain heart interaction to recognize these potentially life-threatening scenarios. How to cite this article Hrishi AP, Lionel KR, Prathapadas U. Head Rules Over the Heart: Cardiac Manifestations of Cerebral Disorders. Indian J Crit Care Med 2019;23(7):329–335.

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Section: Specific Brain Regions and Cardiovascular Changesmentioning

confidence: 99%

Head Rules Over the Heart: Cardiac Manifestations of Cerebral Disorders

Hrishi

Lionel

Prathapadas

2019

Indian Journal of Critical Care Medicine

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“…The brainstem (i.e., the external lateral parabrachial nucleus within the pons and rostral ventrolateral medulla) contributes to CNS processing of excitatory cardiovascular reflexes during cardiac sympathetic stimulation [ 46 , 47 ]. The brainstem is an important regulator of cardiovascular responses to the interactive or exteroceptive environment, as well as vagal and sympathetic nerve activity [ 48 ].…”

Section: Interaction Between Cardiovascular Changes and Specific Bmentioning

confidence: 99%

Neurocardiology: Cardiovascular Changes and Specific Brain Region Infarcts

Zou

Shi

Tao

et al. 2017

BioMed Research International

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There are complex and dynamic reflex control networks between the heart and the brain, including cardiac and intrathoracic ganglia, spinal cord, brainstem, and central nucleus. Recent literature based on animal model and clinical trials indicates a close link between cardiac function and nervous systems. It is noteworthy that the autonomic nervous-based therapeutics has shown great potential in the management of atrial fibrillation, ventricular arrhythmia, and myocardial remodeling. However, the potential mechanisms of postoperative brain injury and cardiovascular changes, particularly heart rate variability and the presence of arrhythmias, are not understood. In this chapter, we will describe mechanisms of brain damage undergoing cardiac surgery and focus on the interaction between cardiovascular changes and damage to specific brain regions.

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Etiology Mechanism of Sudden Death Derived from Brain

Wang

2020

Sudden Death

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elPBN neurons regulate rVLM activity through elPBN-rVLM projections during activation of cardiac sympathetic afferent nerves

Cited by 4 publications

References 47 publications

Head Rules Over the Heart: Cardiac Manifestations of Cerebral Disorders

Head Rules Over the Heart: Cardiac Manifestations of Cerebral Disorders

Neurocardiology: Cardiovascular Changes and Specific Brain Region Infarcts

Etiology Mechanism of Sudden Death Derived from Brain

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