Clinical Neurocardiology Defining the Value of Neuroscience-based Cardiovascular Therapeutics

Overview

Journal J Physiol

Specialty Physiology

Date 2016 Apr 27

PMID 27114333

Citations 140

Authors

Kalyanam Shivkumar

Olujimi A Ajijola

Inder Anand

J Andrew Armour

Peng-Sheng Chen

Murray Esler

Gaetano M De Ferrari

Michael C Fishbein

Jeffrey J Goldberger

Ronald M Harper

Michael J Joyner

Sahib S Khalsa

Rajesh Kumar

Richard Lane

Aman Mahajan

Sunny Po

Peter J Schwartz

Virend K Somers

Miguel Valderrabano

Marmar Vaseghi

Douglas P Zipes

Affiliations

Soon will be listed here.

Abstract

The autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology of many cardiovascular diseases. As such, the value of neuroscience-based cardiovascular therapeutics is increasingly evident. This White Paper reviews the current state of understanding of human cardiac neuroanatomy, neurophysiology, pathophysiology in specific disease conditions, autonomic testing, risk stratification, and neuromodulatory strategies to mitigate the progression of cardiovascular diseases.

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References

Hamann J, Ruble S, Stolen C, Wang M, Gupta R, Rastogi S . Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure. Eur J Heart Fail. 2013; 15(12):1319-26. PMC: 3895958. DOI: 10.1093/eurjhf/hft118. View

Kanazawa H, Ieda M, Kimura K, Arai T, Kawaguchi-Manabe H, Matsuhashi T . Heart failure causes cholinergic transdifferentiation of cardiac sympathetic nerves via gp130-signaling cytokines in rodents. J Clin Invest. 2010; 120(2):408-21. PMC: 2810079. DOI: 10.1172/JCI39778. View

Gray A, Johnson T, Ardell J, Massari V . Parasympathetic control of the heart. II. A novel interganglionic intrinsic cardiac circuit mediates neural control of heart rate. J Appl Physiol (1985). 2004; 96(6):2273-8. DOI: 10.1152/japplphysiol.00616.2003. View

Kember G, Armour J, Zamir M . Dynamic neural networking as a basis for plasticity in the control of heart rate. J Theor Biol. 2012; 317:39-46. DOI: 10.1016/j.jtbi.2012.09.024. View

Kim D, Luthringer D, Lai A, Suh G, Czer L, Chen L . Sympathetic nerve sprouting after orthotopic heart transplantation. J Heart Lung Transplant. 2004; 23(12):1349-58. DOI: 10.1016/j.healun.2003.10.005. View

Han S, Kobayashi K, Joung B, Piccirillo G, Maruyama M, Vinters H . Electroanatomic remodeling of the left stellate ganglion after myocardial infarction. J Am Coll Cardiol. 2012; 59(10):954-61. PMC: 3975658. DOI: 10.1016/j.jacc.2011.11.030. View

Bourke T, Vaseghi M, Michowitz Y, Sankhla V, Shah M, Swapna N . Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation. Circulation. 2010; 121(21):2255-62. PMC: 2896716. DOI: 10.1161/CIRCULATIONAHA.109.929703. View

Kumar R, Woo M, Birrer B, Macey P, Fonarow G, Hamilton M . Mammillary bodies and fornix fibers are injured in heart failure. Neurobiol Dis. 2008; 33(2):236-42. PMC: 2745998. DOI: 10.1016/j.nbd.2008.10.004. View

Allessie M, Lammers W, Bonke I, Hollen J . Intra-atrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog. Circulation. 1984; 70(1):123-35. DOI: 10.1161/01.cir.70.1.123. View

10.

Gray M, Taggart P, Sutton P, Groves D, Holdright D, Bradbury D . A cortical potential reflecting cardiac function. Proc Natl Acad Sci U S A. 2007; 104(16):6818-23. PMC: 1871868. DOI: 10.1073/pnas.0609509104. View

11.

Tsai C, Chen S, Tai C, Chiou C, Prakash V, Yu W . Bezold-Jarisch-like reflex during radiofrequency ablation of the pulmonary vein tissues in patients with paroxysmal focal atrial fibrillation. J Cardiovasc Electrophysiol. 1999; 10(1):27-35. DOI: 10.1111/j.1540-8167.1999.tb00638.x. View

12.

Kumar R, Woo M, Macey P, Fonarow G, Hamilton M, Harper R . Brain axonal and myelin evaluation in heart failure. J Neurol Sci. 2011; 307(1-2):106-13. PMC: 3150745. DOI: 10.1016/j.jns.2011.04.028. View

13.

Rodrigues B, Jorge L, Mostarda C, Rosa K, Medeiros A, Malfitano C . Aerobic exercise training delays cardiac dysfunction and improves autonomic control of circulation in diabetic rats undergoing myocardial infarction. J Card Fail. 2012; 18(9):734-44. DOI: 10.1016/j.cardfail.2012.07.006. View

14.

Collura C, Johnson J, Moir C, Ackerman M . Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery. Heart Rhythm. 2009; 6(6):752-9. DOI: 10.1016/j.hrthm.2009.03.024. View

15.

Schwartz P, Ackerman M . The long QT syndrome: a transatlantic clinical approach to diagnosis and therapy. Eur Heart J. 2013; 34(40):3109-16. DOI: 10.1093/eurheartj/eht089. View

16.

Kumar R, Birrer B, Macey P, Woo M, Gupta R, Yan-Go F . Reduced mammillary body volume in patients with obstructive sleep apnea. Neurosci Lett. 2008; 438(3):330-4. DOI: 10.1016/j.neulet.2008.04.071. View

17.

Roddie I . Human responses to emotional stress. Ir J Med Sci. 1977; 146(12):395-417. DOI: 10.1007/BF03030998. View

18.

Barsky A, Cleary P, BRENER J, Ruskin J . The perception of cardiac activity in medical outpatients. Cardiology. 1993; 83(5-6):304-15. DOI: 10.1159/000175986. View

19.

Cohen M, Taylor J . Short-term cardiovascular oscillations in man: measuring and modelling the physiologies. J Physiol. 2002; 542(Pt 3):669-83. PMC: 2290446. DOI: 10.1113/jphysiol.2002.017483. View

20.

Freedland K, Mohr D, Davidson K, Schwartz J . Usual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions. Psychosom Med. 2011; 73(4):323-35. PMC: 3091006. DOI: 10.1097/PSY.0b013e318218e1fb. View