Translational neurocardiology: preclinical models and cardioneural integrative aspects

Abstract

Neuronal elements distributed throughout the cardiac nervous system, from the level of the insular cortex to the intrinsic cardiac nervous system, are in constant communication with one another to ensure that cardiac output matches the dynamic process of regional blood flow demand. Neural elements in their various 'levels' become differentially recruited in the transduction of sensory inputs arising from the heart, major vessels, other visceral organs and somatic structures to optimize neuronal coordination of regional cardiac function. This White Paper will review the relevant aspects of the structural and functional organization for autonomic control of the heart in normal conditions, how these systems remodel/adapt during cardiac disease, and finally how such knowledge can be leveraged in the evolving realm of autonomic regulation therapy for cardiac therapeutics.

Sympathetic modulation of electrical activation in normal and infarcted myocardium: implications for arrhythmogenesis

“…During exercise, stress, general anesthesia, and sleep, for example, neurotransmission (both sympathetic and parasympathetic) likely modulates the electrophysiologic properties of peri-infarct circuits capable of harboring VT. Therapeutic modulation may be achieved by sympathectomy, vagal stimulation, tragal stimulation, and/or spinal cord stimulation (3,45). These interventions warrant study on how peri-infarct circuits are modulated.…”

Inflammation, oxidative stress, and glial cell activation characterize stellate ganglia from humans with electrical storm

“…The influence of excess sympathetic activation on cardiovascular dysfunction, arrhythmias, and sudden death is well established (1,2). Modulation of adrenergic signaling via pharmacologic and interventional approaches (3)(4)(5)) is emerging as a major therapeutic strategy in managing ischemic (ICM) and nonischemic cardiomyopathy (NICM), and arrhythmias.…”

Integrative Views of the Heart in Chinese and Western Medicine

“…Recently, with the development of neuroanatomy, neurophysiology, and functional imaging technology, a new perspective of the central and peripheral mechanisms of cardiac function in the central nervous system has become possible. Neuronal elements distributed throughout the cardiac nervous system, from the level of the insular cortex to the intrinsic cardiac nervous system, are in constant communication with one another to ensure that cardiac output matches the dynamic process of regional blood flow demand [8]. That means there are actual neural pathways between the heart and central neural system, and maybe one day we can find the mechanism by which the heart affects one's memory and thinking.…”