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Anatomy and Molecular Basis of Autonomic Innervation of the Heart

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Atlas of Cardiac Innervation

Abstract

The heart is innervated extensively by sympathetic and parasympathetic nerves of the peripheral autonomic nervous system, as well as by sensory nerves. Most sympathetic neurons use norepinephrine as a primary neurotransmitter. Acetylcholine is the main neurotransmitter released by preganglionic and postganglionic vagal nerve terminals, which wrap around the heart and activate the parasympathetic nervous system. Sympathetic and parasympathetic systems exert opposite effects on the heart to regulate the contractile rate and force. Sympathetic nerves increase both heart rate (positive chronotropy) and contractile function (positive inotropy), whereas parasympathetic nerves diminish heart rate (bradycardia) and attenuate sympathetic effects on contractile function. Under normal conditions, the two systems are well balanced to maintain a normal response to external stimulation.

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  1. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD, 21201, USA

    Wengen Chen MD, PhD & Vasken Dilsizian MD

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Correspondence to Vasken Dilsizian MD .

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  1. Division of Nuclear Medicine Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Vasken Dilsizian

  2. Division of Cardiology, Mount Sinai Medical Center, New York, New York, USA

    Jagat Narula

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Chen, W., Dilsizian, V. (2017). Anatomy and Molecular Basis of Autonomic Innervation of the Heart. In: Dilsizian, V., Narula, J. (eds) Atlas of Cardiac Innervation. Springer, Cham. https://doi.org/10.1007/978-3-319-45800-7_1

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