Neuro Cardiology | Neurology2018 | Brain-Heart | Neurology Conference 2018

Neuro Cardiology | Neurology2018 | Brain-Heart | Neurology Conference 2018 

Neuro-cardiology refers to the pathophysiological interplays of the nervous and cardiovascular systems. The constant communication between the heart and the brain have proved invaluable to interdisciplinary fields of neurological and cardiac diseases. 

The interaction between heart and brain becomes increasingly important as the underlying mutual mechanisms become better understood. The speciality that deals with the brain-heart connection has become known as neurocardiology. 

Over the past years, there is increasing evidence about the brain-heart interaction with major potential implications for treatment of cardiovascular diseases. For instance, cerebrovascular accidents (CVAs) and transient ischaemic attacks (TIAs) are frequently caused by cardiac arrhythmias and/or congestive heart failure.

Even in the absence of manifest stroke, atrial fibrillation is a risk factor for cognitive impairment and hippocampal atrophy. Therefore, cognition and measures of structural brain integrity should be considered in the evaluation of novel treatments for atrial fibrillation. 

There are complex and dynamic reflex control networks between the heart and the brain, including cardiac and intrathoracic ganglia, spinal cord, brainstem, and central nucleus. Recent literature based on animal model and clinical trials indicates a close link between cardiac function and nervous systems. It is noteworthy that the autonomic nervous-based therapeutics has shown great potential in the management of atrial fibrillation, ventricular arrhythmia, and myocardial remodeling. However, the potential mechanisms of postoperative brain injury and cardiovascular changes, particularly heart rate variability and the presence of arrhythmias, are not understood. In this chapter, we will describe mechanisms of brain damage undergoing cardiac surgery and focus on the interaction between cardiovascular changes and damage to specific brain regions.

Improving our understanding of the mechanisms regulating postoperative brain injury and cardiovascular changes will aid in the development of appropriate therapeutic measures for cardiac surgery patients. Careful management of the operation period and favourable cardiopulmonary bypass conditions, as well as control of temperature, flow rate, pH, and hematocrit levels, can reduce the risk of cerebral infarction and thus avoid autonomic nerve damage and improve the prognosis of patients with cardiac surgery . Similarly, furthering our understanding of the brain-heart axis and how brain lesions result in dynamic changes in ECG and HRV is important for facilitating the treatment of clinical symptoms in patients with brain injury after cardiac surgery.

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