Neurocardiogene

Neurocardiogene, sometimes rendered as neuro‑cardiogenic, refers to physiological processes that involve an interaction between the nervous system and cardiac function, particularly mechanisms in which neural activity influences heart rate, vascular tone, or electrical conduction. The term is most often applied to reflex‑mediated responses such as neurocardiogenic syncope, wherein a sudden drop in blood pressure and heart rate results from abnormal autonomic regulation.

The underlying pathophysiology involves afferent signals from cardiac mechanoreceptors or baroreceptors that travel via the vagus nerve to central autonomic centers. In susceptible individuals, heightened vagal tone or reduced sympathetic output can cause peripheral vasodilation and bradycardia, leading to transient cerebral hypoperfusion. Contributing factors may include emotional stress, prolonged standing, pain, or sudden postural changes.

Clinically, neurocardiogenic phenomena present with dizziness, light‑headedness, visual disturbances, and sometimes brief loss of consciousness. Diagnosis relies on a detailed history, physical examination, and exclusion of cardiac arrhythmias or structural heart disease. Tilt‑table testing, with or without pharmacologic provocation, is commonly employed to reproduce the reflex and document hemodynamic changes.

Management emphasizes avoidance of precipitating triggers, adequate hydration, and physical counter‑pressure maneuvers. Pharmacologic options may include fludrocortisone to expand plasma volume, midodrine to increase peripheral resistance, or selective serotonin reuptake inhibitors for modulating autonomic tone. In refractory cases, pacemaker implantation has been considered for severe bradycardia.

Research continues to explore genetic predisposition, central autonomic network dysfunction, and novel neuromodulatory therapies. Understanding neurocardiogene mechanisms is integral to differentiating reflex‑mediated syncope from other cardiogenic causes and guiding appropriate treatment strategies.