Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation

Mehra, Reena; Tjurmina, Olga A.; Ajijola, Olujimi A.; Arora, Rishi; Bolser, Donald C.; Chapleau, Mark W.; Chen, Peng‐Sheng; Clancy, Colleen E.; Delisle, Brian P.; Gold, Michael R.; Goldberger, Jeffrey J.; Goldstein, David S.; Habecker, Beth A.; Handoko, M. Louis; Harvey, Robert D.; Hummel, James P.; Hund, Thomas J.; Meyer, Christian; Redline, Susan; Ripplinger, Crystal M.; Simon, Marc A.; Somers, Virend K.; Stavrakis, Stavros; Taylor‐Clark, Thomas E.; Undem, Bradley J.; Verrier, Richard L.; Zucker, Irving H.; Sopko, George; Shivkumar, Kalyanam

doi:10.1016/j.jacbts.2021.11.003

Cited by 28 publications

(22 citation statements)

References 203 publications

(225 reference statements)

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“…40,41 There is an excellent review of cardiopulmonary afferents in health and disease states in a recent National Institutes of Health (NIH)-directed workshop. 44 In summary, these findings demonstrate the importance of cardiac afferents affecting overall sympathetic outflow including the renal nerves and thus having their effect on renal function discussed in more detail below. The Figure summarizes the potential role of the cardiac afferents via actions within the NTS, PVN, and rostral ventrolateral medulla (RVLM) to mediate the regulation of sympathetic outflow to the heart and the kidneys establishing a critical link between the two organs in sympatho-excitatory disease states such as the cardiorenal syndrome.…”

Section: Nonstandard Abbreviations and Acronymsmentioning

confidence: 56%

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Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

Patel

Katsurada

Zheng

2022

Circulation Research

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The maintenance of cardiovascular homeostasis is highly dependent on tightly controlled interactions between the heart and the kidneys. Therefore, it is not surprising that a dysfunction in one organ affects the other. This interlinking relationship is aptly demonstrated in the cardiorenal syndrome. The characteristics of the cardiorenal syndrome state include alterations in neurohumoral drive, autonomic reflexes, and fluid balance. The evidence suggests that several factors contribute to these alterations. These may include peripheral and central nervous system abnormalities. However, accumulating evidence from animals with experimental models of congestive heart failure and renal dysfunction as well as humans with the cardiorenal syndrome suggests that alterations in neural pathways, from and to the kidneys and the heart, including the central nervous system are involved in regulating sympathetic outflow and may be critically important in the alterations in neurohumoral drive, autonomic reflexes, and fluid balance commonly observed in the cardiorenal syndrome. This review focuses on studies implicating neural pathways, particularly the afferent and efferent signals from the heart and the kidneys integrating at the level of the paraventricular nucleus in the hypothalamus to alter neurohumoral drive, autonomic pathways, and fluid balance. Further, it explores the potential mechanisms of action for the known beneficial use of various medications or potential novel therapeutic manipulations for the treatment of the cardiorenal syndrome. A comprehensive understanding of these mechanisms will enhance our ability to treat cardiorenal conditions and their cardiovascular complications more efficaciously and thoroughly.

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Section: Nonstandard Abbreviations and Acronymsmentioning

confidence: 56%

“…40,41 There is an excellent review of cardiopulmonary afferents in health and disease states in a recent National Institutes of Health (NIH)-directed workshop. 44…”

Section: Neural Connection Between the Heart And The Kidneymentioning

confidence: 99%

Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

Patel

Katsurada

Zheng

2022

Circulation Research

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“…The autonomic nervous system is well known to play an integral role in the development and progression of atrial fibrillation (AF) as well as in sleep and circadian rhythm pathophysiology [ 1 ]. More than a century ago, vagal stimulation was found to be an adequate method for obtaining AF [ 2 ].…”

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confidence: 99%

“…Screening for the often underdiagnosed OSA in patients with recurrent AF after either cardioversion or ablation is recommended by the American Heart Association [ 5 ]. However, even though OSA and AF often coexist, their relationship has been frequently discussed, with several potential underlying mechanisms being suggested [ 1 ]. Chronic recurrence of intermittent hypoxia with acute alteration in intrathoracic pressure may lead to long-term atrial remodeling altering atrial electrophysiology [ 5 ].…”

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confidence: 99%

The autonomic nervous system as a piece of the mechanistic puzzle linking sleep and atrial fibrillation

Meyer

Kahle

2022

J Interv Card Electrophysiol

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“…This concept is interesting, novel, and timely, and is emphasized by the interest of the National Heart Lung and Blood Institute in identifying research opportunities that further our understanding of cardiopulmonary diseases. 11…”

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confidence: 99%

Chronic Kidney Disease: A Nerve-Racking Situation for the Heart

Ajijola¹

2022

Circulation Research

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Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation

Cited by 28 publications

References 203 publications

Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

The autonomic nervous system as a piece of the mechanistic puzzle linking sleep and atrial fibrillation

Chronic Kidney Disease: A Nerve-Racking Situation for the Heart

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