Neurocardiac

Neurocardiac refers to the interrelationship between the nervous system and the heart, encompassing how neural inputs regulate cardiac function and how cardiac status can influence neural activity. The autonomic nervous system provides rapid, reflexive control through sympathetic and parasympathetic pathways. Sympathetic stimulation increases heart rate, contractility, and conduction velocity, while parasympathetic (vagal) activity slows heart rate. Central networks in the brainstem, hypothalamus, and cortical areas coordinate these commands and respond to physiological and emotional stimuli. Peripherally, sympathetic neurons innervate the myocardium and vasculature, and parasympathetic fibers mainly reach the sinoatrial and atrioventricular nodes.

Key mechanisms and measures include baroreflex and other reflexes that maintain blood pressure and heart rate, as well as neurohumoral signaling involving catecholamines and neuropeptides that modulate myocardial function. Heart rate variability is often used as a noninvasive marker of autonomic balance.

Clinical relevance centers on how neural control dysregulation contributes to cardiovascular conditions. Neurocardiogenic or vasovagal syncope results from exaggerated autonomic reflexes. Takotsubo cardiomyopathy, or stress cardiomyopathy, involves a surge of catecholamines with transient systolic dysfunction. Diabetic autonomic neuropathy can impair heart rate response and blood pressure regulation. Autonomic dysfunction may also occur after stroke, spinal cord injury, or other neurological disorders, affecting prognosis and treatment.

In practice, neurocardiology or neurocardiac approaches study brain–heart interactions using autonomic testing, imaging, and heart rate variability to improve diagnosis, risk assessment, and management of cardiovascular diseases.