Brain-Heart Axis and the Inflammatory Response: Connecting Stroke and Cardiac Dysfunction

Chen, Xiaosheng; Gu, Jiajie; Zhang, Xiaojia

doi:10.1159/000538409

Cited by 2 publications

(1 citation statement)

References 142 publications

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“…Additionally, certain cardiovascular conditions may act as intermediate factors in stroke occurrence. For example, Sariah Khormaee et al observed that patients with new-onset atrial fibrillation post-THR or TKR had a 2.7-fold increased risk of ischemic stroke within 1 year, supporting the brain-heart axis theory ( Khormaee et al, 2018 ; Chen et al, 2024 ). Furthermore, we speculate that the body’s inflammatory response post-surgery might also impact stroke incidence.…”

Section: Discussionmentioning

confidence: 98%

Mendelian randomization of stroke risk after total hip and knee replacements

Pang,

Zheng,

et al. 2024

Front. Genet.

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ObjectivePrevious epidemiological studies have indicated an increased risk of neurovascular diseases in patients following total hip and knee replacements. However, definitive conclusions regarding the increased risk of stroke post-replacement remain elusive. Therefore, we conducted a two-sample Mendelian randomization study to investigate the causal relationship between total hip and knee replacements and stroke.MethodsWe utilized summary data from publicly available genome-wide association studies (GWAS). Data concerning total hip replacements (THR, N = 319,037) and total knee replacements (TKR, N = 252,041) were sourced from the Genetics of Osteoarthritis (GO) Consortium. Stroke-related data were obtained from the International Stroke Genetics Consortium, encompassing any stroke (AS), any ischemic stroke (AIS), large vessel ischemic stroke (LV-IS), cardioembolic ischemic stroke (CE-IS), and small vessel ischemic stroke (SV-IS). Our primary causal inference method was the inverse variance weighted (IVW) approach, supplemented by weighted median and MR-Egger regression as secondary inference methods. We utilized the MR-PRESSO global test for outlier detection, Cochran’s Q statistic to assess heterogeneity, and assessed the multiplicity and stability of our findings using p-values from MR-PRESSO and MR-Egger regressions, and the leave-one-out method, respectively.ResultsWe identified significant genetic associations between THR and both AS (IVW p = 0.0001, OR = 1.08, 95% CI = 1.04–1.12) and AIS (IVW p = 0.0016, OR = 1.07, 95% CI = 1.03–1.12). Significant associations were also observed between TKR and AS (IVW p = 0.0002, OR = 1.08, 95% CI = 1.04–1.12), as well as AIS (IVW p = 0.0005, OR = 1.15, 95% CI = 1.06–1.24).ConclusionOur findings genetically support an increased risk of stroke following total hip and knee replacements. However, further studies are necessary to elucidate the specific mechanisms underlying stroke episodes post-replacement.

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Section: Discussionmentioning

confidence: 98%

Mendelian randomization of stroke risk after total hip and knee replacements

Pang,

Zheng,

et al. 2024

Front. Genet.

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Cognitive Impairment and Synaptic Dysfunction in Cardiovascular Disorders: The New Frontiers of the Heart–Brain Axis

Soda,

Pasqua,

De Sarro

et al. 2024

Biomedicines

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Within the central nervous system, synaptic plasticity, fundamental to processes like learning and memory, is largely driven by activity-dependent changes in synaptic strength. This plasticity often manifests as long-term potentiation (LTP) and long-term depression (LTD), which are bidirectional modulations of synaptic efficacy. Strong epidemiological and experimental evidence show that the heart–brain axis could be severely compromised by both neurological and cardiovascular disorders. Particularly, cardiovascular disorders, such as heart failure, hypertension, obesity, diabetes and insulin resistance, and arrhythmias, may lead to cognitive impairment, a condition known as cardiogenic dementia. Herein, we review the available knowledge on the synaptic and molecular mechanisms by which cardiogenic dementia may arise and describe how LTP and/or LTD induction and maintenance may be compromised in the CA1 region of the hippocampus by heart failure, metabolic syndrome, and arrhythmias. We also discuss the emerging evidence that endothelial dysfunction may contribute to directly altering hippocampal LTP by impairing the synaptically induced activation of the endothelial nitric oxide synthase. A better understanding of how CV disorders impact on the proper function of central synapses will shed novel light on the molecular underpinnings of cardiogenic dementia, thereby providing a new perspective for more specific pharmacological treatments.

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Brain-Heart Axis and the Inflammatory Response: Connecting Stroke and Cardiac Dysfunction

Cited by 2 publications

References 142 publications

Mendelian randomization of stroke risk after total hip and knee replacements

Mendelian randomization of stroke risk after total hip and knee replacements

Cognitive Impairment and Synaptic Dysfunction in Cardiovascular Disorders: The New Frontiers of the Heart–Brain Axis

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