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Brain-Heart Afferent-Efferent Traffic

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Brain and Heart Dynamics

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Abstract

The understanding of cardiac neuronal control has dramatically evolved in the last 50 years, both from an anatomical and a functional point of view. Cardiac neuronal control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis. This neuronal control system shows plasticity and memory capacity, allowing it to maintain an adequate cardiac function in response to normal physiological stressors such as standing and exercise. Yet, pathological events such as myocardial ischemia as well as any other type of cardiac stressor may overcome the homeostatic capability of the system, leading to excessive sympathoexcitation coupled with withdrawal of central parasympathetic drive. In turn, autonomic dysregulation is central to the evolution of heart failure and the development of life-threatening arrhythmias. As such, understanding the anatomical and physiological basis for cardiac neuronal control is crucial to implement effectively novel neuromodulation therapies to mitigate the progression of cardiac disease.

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Authors and Affiliations

  1. Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy

    V. Dusi

  2. Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    V. Dusi

  3. Neurocardiology Research Center of Excellence, University of California, Los Angeles, CA, USA

    Jeffrey L. Ardell

  4. Cardiac Arrhythmia Center, University of California, Los Angeles, CA, USA

    Jeffrey L. Ardell

Authors
  1. V. Dusi
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  2. Jeffrey L. Ardell
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Correspondence to V. Dusi .

Editor information

Editors and Affiliations

  1. Dept of Drug Sciences, Pharmacology Sect, University of Pavia, Dept of Drug Sciences, Pharmacology Sect, Pavia, Pavia, Italy

    Stefano Govoni

  2. Dept of Brain and Behavioural Sciences, University of Pavia Dept of Brain and Behavioural Sciences, Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Department of Molecular Medicine, Pavia, Pavia, Italy

    Emilio Vanoli

Section Editor information

  1. Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy

    Alessia Pascale PhD

  2. Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy

    Emilia d'Elia

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Dusi, V., Ardell, J.L. (2020). Brain-Heart Afferent-Efferent Traffic. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-319-90305-7_2-1

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