Neurological Disorders and Risk of Arrhythmia

Abstract

Neurological disorders including depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, autism and epilepsy are associated with an increased incidence of cardiovascular disorders and susceptibility to heart failure. The underlying molecular mechanisms that link neurological disorders and adverse cardiac function are poorly understood. Further, a lack of progress is likely due to a paucity of studies that investigate the relationship between neurological disorders and cardiac electrical activity in health and disease. Therefore, there is an important need to understand the spatiotemporal behavior of neurocardiac mechanisms. This can be advanced through the identification and validation of neurological and cardiac signaling pathways that may be adversely regulated. In this review we highlight how dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis, autonomic nervous system (ANS) activity and inflammation, predispose to psychiatric disorders and cardiac dysfunction. Moreover, antipsychotic and antidepressant medications increase the risk for adverse cardiac events, mostly through the block of the human ether-a-go-go-related gene (hERG), which plays a critical role in cardiac repolarization. Therefore, understanding how neurological disorders lead to adverse cardiac ion channel remodeling is likely to have significant implications for the development of effective therapeutic interventions and helps improve the rational development of targeted therapeutics with significant clinical implications.

Storax, A Promising Botanical Medicine for Treating Cardio-Cerebrovascular Diseases: A Review

“…Arrhythmia refers to the abnormality of cardiac rhythm, frequency, or activation sequence caused by cardiac pacing and conduction dysfunction, mainly manifested as tachycardia, bradycardia, arrhythmia, conduction block and arrest, which can lead to syncope, sudden death, and other critical situations ( Bernardi et al, 2020 ). Modern antiarrhythmic drugs for arrhythmia are effective but have a large number of adverse effects, in addition to liver and kidney damage, and even some antiarrhythmic drugs have the same arrhythmogenic adverse effects ( Wang X. et al, 2013 ).…”

Heart Rate Variability in Schizophrenia and Autism

“…Responses were scored as following: "Never" (1), "Rarely" (2), "Sometimes" (3), "Often" (4). Questions 1,4,5,6,7,19,15,16,19, and 20 were reverse scored. Scores were then summed to create an index of loneliness where higher scores reflect greater feelings of loneliness.…”

“…However, understanding the perturbed mechanisms specific to each condition can reveal subtle markers of unique psychopathology. Altered autonomic functioning is common across both autism and schizophrenia and is related to several comorbid conditions including cardiac, gastrointestinal, and autoimmune disorders (6)(7)(8). A common measure of autonomic functioning that has been shown to be abnormal in both schizophrenia and autism is reduced heart rate variability (HRV) (9)(10)(11).…”

Mechanisms Underlying Antiarrhythmic Properties of Cardioprotective Agents Impacting Inflammation and Oxidative Stress

“…The cardiovascular risk factors that predispose to arrhythmias are accompanied by low grade inflammation and oxidative stress. These factors include hypertension, obesity, insulin resistance, metabolic syndrome, ageing, neurological disorders and circadian rhythm disruption [16,38,40,63,[69][70][71][72][73][74][75][76][77][78][79][80]. These conditions cause pro-arrhythmic load and predisposition to acute heart attack and stroke.…”