Cardiovascular pathophysiology from the cardioneural perspective and its clinical applications

• Type of Material: Article
• Authors: Amit Shah, Emory University; Matthew T Wittbrodt, Emory University; James Bremner, Emory University; Viola Vaccarino, Emory University
• Language: English
• Date: 2022-02-25
• Publisher: ELSEVIER SCIENCE LONDON
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.tcm.2021.03.001
• Title of Journal or Parent Work: TRENDS IN CARDIOVASCULAR MEDICINE
• Volume: 32
• Issue: 3
• Start Page: 172
• End Page: 177
• Grant/Funding Information: NIH K23 HL127251, R03 HL146879, P01 HL101398, R01 HL088726, K24 MH076955, T32MH067547, R01 MH56120, K24 HL077506, R01 HL068630, R01 HL109413, R01 HL125246, ULTR002378, and S10 RR16917
• Keywords: MENTAL STRESS; Neurocardiology; RISK; Life Sciences & Biomedicine; HEART-RATE-VARIABILITY; METAANALYSIS; Heart rate variability; Science & Technology; Cardiac & Cardiovascular Systems; ASSOCIATION; Cardiovascular System & Cardiology; MODULATION; POSTTRAUMATIC-STRESS-DISORDER; DYSFUNCTION; ANATOMY; MYOCARDIAL-INFARCTION; Autonomic nervous system

Abstract

Coronary heart disease and psychological stress factors such as depression are prevalent and associated with high morbidity/mortality; they are also challenging to manage, especially when treated in isolation of each other. Recent advances support an integrated approach to their management that is built on a foundation of an extensive, multi-component network of neurological structures. In this review, we describe this extensive cardioneural network that encompasses the heart, brain, spinal cord, and ganglia throughout the body, and then discuss ambulatory and laboratory-based non-invasive measures of this network that both measure psychological stress and heart disease severity. Lastly, we discuss their potential transformative clinical and public health applications, and also possible cardioneural interventions such as exercise and biofeedback.