Brain, heart, and sudden death

Abstract

During the past 30 years, rate of coronary artery disease (CAD), as the main cause of sudden death (SD), has decreased more than rate of SD. Likewise, cause of SD remains elusive in not a trivial portion of its victims. One possible reason is attention to only one organ, the heart, as the cause of SD. In fact, SD literature focuses more on the heart, less on the brain, and seldom on both. A change is required. In this paper, we first review the pathological findings seen in heart autopsies of SD victims after psychological stressors such as physical assault victims without internal injuries. Then, we summarize new studies investigating brain areas, like the insula, whose malfunctions and injuries are related to SD. Next, we review prototypes of neurological diseases and psychological stressors associated with SD and look at heart failure (HF)-related SD providing evidence for the brain-heart connection. Finally, we propose a new look at SD risk factors considering both brain and heart in their association with SD, and review strategies for prevention of SD from this perspective.

Autonomic brain functioning and age-related health concerns

“…Cardiovascular diseases are the leading cause of mortality among those aged 65 and older, and hypertension plays at least some role in this manner ( Wu et al, 2015 ). Similarly, a decrease in PNS activity is associated with an increase in the development of arrhythmia and age-related cardiac deaths ( Freeling and Li, 2015 ; Oveisgharan et al, 2022 ). The ANS is one of the body organs that is dysregulated with advancing age, and the effects of aging on the structures and functions of body organs are illustrated in Fig.…”

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Fig. 3 The effects of normal aging on the structures and functions of body organs ( Freeling and Li, 2015 ; Oveisgharan et al, 2022 ).

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