Cardiac Innervation and Sudden Cardiac Death

Circulation Research, Journal Year: 2015, Volume and Issue: 116(12), P. 2005 - 2019

Published: June 4, 2015

Afferent and efferent cardiac neurotransmission via the nerves intricately modulates nearly all physiological functions of heart (chronotropy, dromotropy, lusitropy, inotropy). information from is transmitted to higher levels nervous system for processing (intrinsic system, extracardiac-intrathoracic ganglia, spinal cord, brain stem, centers), which ultimately results in cardiomotor neural impulses (via sympathetic parasympathetic nerves). This forms interacting feedback loops that provide stability maintaining normal rhythm life-sustaining circulation. also ensures there fine-tuned regulation sympathetic–parasympathetic balance under stressed states short (beat beat), intermediate (minutes hours), long term (days years). important neurovisceral/autonomic plays a major role pathophysiology progression disease, including failure arrhythmias leading sudden death. Transdifferentiation neurons failure, functional denervation, extracardiac remodeling has been identified characterized during disease. Recent advances understanding cellular molecular processes governing innervation control myocardium health disease rational mechanistic basis development neuraxial therapies preventing death other arrhythmias. Advances cellular, molecular, bioengineering realms have underscored emergence this area as an avenue scientific inquiry therapeutic intervention.

Language: Английский

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Regulation of Breathing and Autonomic Outflows by Chemoreceptors

Comprehensive physiology, Journal Year: 2014, Volume and Issue: unknown, P. 1511 - 1562

Published: Sept. 30, 2014

Lung ventilation fluctuates widely with behavior but arterial PCO2 remains stable. Under normal conditions, the chemoreflexes contribute to PaCO2 stability by producing small corrective cardiorespiratory adjustments mediated lower brainstem circuits. Carotid body (CB) information reaches respiratory pattern generator (RPG) via nucleus solitarius (NTS) glutamatergic neurons which also target rostral ventrolateral medulla (RVLM) presympathetic thereby raising sympathetic nerve activity (SNA). Chemoreceptors regulate and cardiovagal preganglionic indirectly inputs from RPG. Secondary effects of chemoreceptors on autonomic outflows result changes in lung stretch afferent baroreceptor activity. Central chemosensitivity is caused direct acid indirect CO2 astrocytes. are not definitively identified retrotrapezoid (RTN) a particularly strong candidate. The absence RTN likely causes severe central apneas congenital hypoventilation syndrome. Like other stressors, intense chemosensory stimuli produce arousal activate circuits that wake- or attention-promoting. Such pathways (e.g., locus coeruleus, raphe, orexin system) modulate state-dependent manner their activation intensifies these reflexes. In essential hypertension, obstructive sleep apnea congestive heart failure, chronically elevated CB contributes SNA breathing unchanged becomes periodic (severe CHF). Extreme CNS hypoxia produces stereotyped response (gasping, increased SNA). various pathologies networks discussed, special consideration being given interactions between peripheral chemoreflexes. © 2014 American Physiological Society. Compr Physiol 4:1511-1562, 2014.

Language: Английский

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Clinical neurocardiology defining the value of neuroscience-based cardiovascular therapeutics

The Journal of Physiology, Journal Year: 2016, Volume and Issue: 594(14), P. 3911 - 3954

Published: April 27, 2016

The autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology many cardiovascular diseases. As such, value neuroscience-based therapeutics increasingly evident. This White Paper reviews current state understanding human neuroanatomy, neurophysiology, specific disease conditions, testing, risk stratification, neuromodulatory strategies mitigate progression

Language: Английский

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Effect of acute hypoxia on cognition: A systematic review and meta-regression analysis

Neuroscience & Biobehavioral Reviews, Journal Year: 2017, Volume and Issue: 74, P. 225 - 232

Published: Jan. 19, 2017

Language: Английский

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C1 neurons mediate a stress-induced anti-inflammatory reflex in mice

Nature Neuroscience, Journal Year: 2017, Volume and Issue: 20(5), P. 700 - 707

Published: March 13, 2017

Language: Английский

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Translational neurocardiology: preclinical models and cardioneural integrative aspects

The Journal of Physiology, Journal Year: 2016, Volume and Issue: 594(14), P. 3877 - 3909

Published: April 21, 2016

Abstract Neuronal elements distributed throughout the cardiac nervous system, from level of insular cortex to intrinsic are in constant communication with one another ensure that output matches dynamic process regional blood flow demand. Neural their various ‘levels’ become differentially recruited transduction sensory inputs arising heart, major vessels, other visceral organs and somatic structures optimize neuronal coordination function. This White Paper will review relevant aspects structural functional organization for autonomic control heart normal conditions, how these systems remodel/adapt during disease, finally such knowledge can be leveraged evolving realm regulation therapy therapeutics.

Language: Английский

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Developing the catecholamines hypothesis for the acute exercise-cognition interaction in humans: Lessons from animal studies

Physiology & Behavior, Journal Year: 2016, Volume and Issue: 165, P. 291 - 299

Published: Aug. 14, 2016

Language: Английский

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Neuropeptide and Small Transmitter Coexistence: Fundamental Studies and Relevance to Mental Illness

Frontiers in Neural Circuits, Journal Year: 2018, Volume and Issue: 12

Published: Dec. 21, 2018

Neuropeptide are auxiliary messenger molecules that always co-exist in nerve cells with one or more small-molecule (classic) neurotransmitters. Neuropeptides act both as transmitters and trophic factors, play a role especially when the nervous system is challenged, by injury, pain stress. Here neuropeptides coexistence mammals reviewed, but special focus on 29/30 amino acid galanin its three receptors GalR1, -R2 -R3. In particular, galanin's co-transmitter rodent human noradrenergic locus coeruleus (LC) neurons addressed. Extensive experimental animal data strongly suggest for depression–like behavior. The translational potential of these results was tested studying postmortem brains, first normal then comparing five regions brains obtained from depressed people who committed suicide, matched controls. It hypothesized that, exposed to severe stress, LC fire bursts release their soma/dendrites. Galanin acts somato-dendritic, inhibitory GalR3 autoreceptors, opening potassium channels inhibiting firing. purpose autoreceptors 'brake' prevent overexcitation, brake also part resilience stress protects against depression. Depression arises inhibition too strong long lasting - maladaption, allostatic load, leading depletion NA levels forebrain. suggested disinhibition antagonist may have antidepressant activity restituting forebrain levels. A depression supported recent candidate gene study, showing variants genes confer increased risk anxiety experienced childhood adversity negative life events. Taken together, neuropeptide galanin, coexisting neurons, participate mechanism underlying serious common disorder, MDD. These lead an understanding how this illness develops which turn can provide basis treatment.

Language: Английский

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The extended autonomic system, dyshomeostasis, and COVID-19

Clinical Autonomic Research, Journal Year: 2020, Volume and Issue: 30(4), P. 299 - 315

Published: July 22, 2020

The pandemic viral illness COVID-19 is especially life-threatening in the elderly and those with any of a variety chronic medical conditions. This essay explores possibility that heightened risk may involve activation "extended autonomic system" (EAS). Traditionally, nervous system has been viewed as consisting sympathetic system, parasympathetic enteric system. Over past century, however, neuroendocrine neuroimmune systems have come to fore, justifying expansion meaning "autonomic." Additional facets include adrenergic for which adrenaline key effector; hypothalamic-pituitary-adrenocortical axis; arginine vasopressin (synonymous anti-diuretic hormone); renin-angiotensin-aldosterone angiotensin II aldosterone main effectors; cholinergic anti-inflammatory inflammasomal pathways. A hierarchical brain network-the "central network"-regulates these systems; embedded within it are components Chrousos/Gold "stress system." Acute, coordinated alterations homeostatic settings (allostasis) can be crucial surviving stressors such traumatic hemorrhage, asphyxiation, sepsis, throughout human evolution threatened homeostasis; intense or long-term EAS cause harm. While required appropriate responses emergencies, setting chronically decreased efficiencies (dyshomeostasis) reduce thresholds induction destabilizing, lethal vicious cycles. Testable hypotheses derived from concepts biomarkers correlate clinical pathophysiologic data predict outcome treatments targeting specific abnormalities identified individual patients beneficial.

Language: Английский

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Brain metabolic sensing and metabolic signaling at the level of an astrocyte

Glia, Journal Year: 2017, Volume and Issue: 66(6), P. 1185 - 1199

Published: Dec. 23, 2017

Abstract Astrocytes support neuronal function by providing essential structural and nutritional support, neurotransmitter trafficking recycling may also contribute to brain information processing. In this article we review published results report new data suggesting that astrocytes as versatile metabolic sensors of central nervous system (CNS) milieu play an important role in the maintenance homeostasis. We discuss anatomical functional features allow them detect respond changes parenchymal levels substrates (oxygen glucose), waste products (carbon dioxide). are sensitive circulating endocrine signals—hormones like ghrelin, glucagon‐like peptide‐1 leptin, have a major impact on CNS mechanisms controlling food intake energy balance. signaling mediate communication between neurons consider how these recruited activated response various challenges. experimental modulate activities respiratory autonomic networks ensure adaptive breathing sympathetic drive order physiological behavioral demands organism ever‐changing environmental conditions. Finally, evidence altered astroglial pathogenesis disparate neurological, cardiovascular disorders such Rett syndrome systemic arterial hypertension.

Language: Английский

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