Espinoza Liliana, Fedorchak Stephanie, Boychuk Carie R
Department of Cellular and Integrative Physiology, Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, United States.
Front Physiol. 2021 Mar 11;12:624595. doi: 10.3389/fphys.2021.624595. eCollection 2021.
There is consensus that the heart is innervated by both the parasympathetic and sympathetic nervous system. However, the role of the parasympathetic nervous system in controlling cardiac function has received significantly less attention than the sympathetic nervous system. New neuromodulatory strategies have renewed interest in the potential of parasympathetic (or vagal) motor output to treat cardiovascular disease and poor cardiac function. This renewed interest emphasizes a critical need to better understand how vagal motor output is generated and regulated. With clear clinical links between cardiovascular and metabolic diseases, addressing this gap in knowledge is undeniably critical to our understanding of the interaction between metabolic cues and vagal motor output, notwithstanding the classical role of the parasympathetic nervous system in regulating gastrointestinal function and energy homeostasis. For this reason, this review focuses on the central, vagal circuits involved in sensing metabolic state(s) and enacting vagal motor output to influence cardiac function. It will review our current understanding of brainstem vagal circuits and their unique position to integrate metabolic signaling into cardiac activity. This will include an overview of not only how metabolic cues alter vagal brainstem circuits, but also how vagal motor output might influence overall systemic concentrations of metabolic cues known to act on the cardiac tissue. Overall, this review proposes that the vagal brainstem circuits provide an integrative network capable of regulating and responding to metabolic cues to control cardiac function.
人们一致认为，心脏受副交感神经系统和交感神经系统的双重支配。然而，与交感神经系统相比，副交感神经系统在控制心脏功能方面所起的作用受到的关注要少得多。新的神经调节策略重新激发了人们对副交感神经（或迷走神经）运动输出治疗心血管疾病和心脏功能不佳潜力的兴趣。这种重新燃起的兴趣凸显了迫切需要更好地了解迷走神经运动输出是如何产生和调节的。鉴于心血管疾病和代谢性疾病之间存在明确的临床联系，尽管副交感神经系统在调节胃肠功能和能量稳态方面具有经典作用，但填补这一知识空白对于我们理解代谢信号与迷走神经运动输出之间的相互作用无疑至关重要。出于这个原因，本综述重点关注参与感知代谢状态并产生迷走神经运动输出以影响心脏功能的中枢迷走神经回路。它将回顾我们目前对脑干迷走神经回路及其将代谢信号整合到心脏活动中的独特地位的理解。这不仅将包括代谢信号如何改变迷走神经脑干回路的概述，还将包括迷走神经运动输出如何可能影响已知作用于心脏组织的代谢信号的整体全身浓度。总体而言，本综述提出，迷走神经脑干回路提供了一个能够调节和响应代谢信号以控制心脏功能的整合网络。
