Swenne Cees A, Shusterman Vladimir
Cardiology Department, Leiden University Medical Center, Leiden, The Netherlands.
Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America.
J Electrocardiol. 2025 Jan-Feb;88:153836. doi: 10.1016/j.jelectrocard.2024.153836. Epub 2024 Nov 22.
Neurocardiology is a broad interdisciplinary specialty investigating how the cardiovascular and nervous systems interact. In this brief introductory review, we describe several key aspects of this interaction with specific attention to cardiovascular effects. The review introduces basic anatomy and discusses physiological mechanisms and effects that play crucial roles in the interaction of the cardiovascular and nervous systems, namely: the cardiac neuraxis, the taxonomy of the nervous system, integration of sensory input in the brainstem, influences of the autonomic nervous system (ANS) on heart and vasculature, the neural pathways and functioning of the arterial baroreflex, receptors and ANS effects in the walls of blood vessels, receptors and ANS effects in excitable cells in the heart, ANS effects on heart rate and sympathovagal balance, endo-epicardial inhomogeneity, ANS effects with a balanced vagal and sympathetic stimulation, sympathovagal interaction, arterial baroreflex, baroreflex sensitivity and heart rate variability, arrhythmias and the arterial baroreflex, the cardiopulmonary baroreflex, the exercise pressor reflex, exercise-recovery hysteresis, mental stress, cardiac-cardiac reflexes, the cardiac sympathetic afferent reflex (CSAR), and neuromodulation. Also, the potential role of the discussed mechanisms in cardiovascular disorders will be touched upon.
神经心脏病学是一门广泛的跨学科专业,研究心血管系统和神经系统如何相互作用。在这篇简短的介绍性综述中,我们描述了这种相互作用的几个关键方面,并特别关注心血管效应。该综述介绍了基本解剖结构,并讨论了在心血管系统和神经系统相互作用中起关键作用的生理机制和效应,即:心脏神经轴、神经系统的分类、脑干中感觉输入的整合、自主神经系统(ANS)对心脏和血管的影响、动脉压力反射的神经通路和功能、血管壁中的受体和ANS效应、心脏中可兴奋细胞中的受体和ANS效应、ANS对心率和交感迷走神经平衡的影响、心内膜-心外膜不均一性、迷走神经和交感神经平衡刺激下的ANS效应、交感迷走神经相互作用、动脉压力反射、压力反射敏感性和心率变异性、心律失常与动脉压力反射、心肺压力反射、运动升压反射、运动-恢复滞后、精神压力、心脏-心脏反射、心脏交感传入反射(CSAR)以及神经调节。此外,还将探讨所讨论的机制在心血管疾病中的潜在作用。