Heart and Brain Interaction and Autonomic Modulation in Heart Failure
Pattara Rattanawong1, Vichai Senthong2
Affiliation : 1 Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA, 2 Cardiovascular Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Neurocardiac axis connects the heart and brain through insular cortex, the anterior cingulate cortex, the prefrontal cortex, the amygdala, sympathetic nervous system inhibition reflex, and cardiopulmonary baroreceptors. Sympathetic over-activation and dysregulation of fluid homeostasis through the brain and neurocardiac axis is the important causes of left ventricular remodeling and symptom aggravation in HF. Modulation of autonomic nervous system including activation of the sympathetic nervous system and inhibition of the parasympathetic nervous system are manifestations of the clinical syndrome of HF. Activation of neurocardiac axis, especially the sympathetic nervous system, and neurohumoral systems, the renin-angiotensin-aldosterone system, by impaired cardiac function, play a major role in the progression of HF. β-blockers have been well studied and have been reported to reverse ventricular remodeling and decrease mortality in patients with HF. In addition, vagal stimulation showed effectiveness and favorable results in animal studies and may have subjective benefits in HF patients.
DOI:10.35755/jmedassocthai.2023.S01.13793
Keywords : Heart failure; Autonomic nervous system
All Articles
Download