Stressed brain, diseased heart: A review on the pathophysiologic mechanisms of neurocardiology

Abstract

Cardiovascular diseases are traditionally related to well known risk factors like dyslipidemia, smoking, diabetes and hypertension. More recently, stress, anxiety and depression have been proposed as risk factors for cardiovascular diseases including heart failure, ischemic disease, hypertension and arrhythmias. Interestingly, this association has been established largely on the basis of epidemiological data, due to insufficient knowledge on the underlying pathophysiologic mechanisms. This review will revisit evidence on the interaction between the cardiovascular and nervous systems, highlighting the perspective on how the central nervous system is involved in the pathogenesis of cardiovascular diseases. Such knowledge is likely to be of relevance for the development of better strategies to treat patients in a holistic perspective.

Differences in autonomic functions as related to induced stress between children with and without cerebral palsy while performing a virtual meal-making task

“…Chronic activation of the sympathetic system and/or decreased and disorganized parasympathetic activity is associated with a narrow range of behavioral adaptation to challenging situations (Pereira, Cerqueira, Palha, & Sousa, 2013). It is also a predictor of stress and vulnerability, and a risk factor for cardiovascular disorder (Pereira et al, 2013;Schaaf et al, 2010).…”

“…It is also a predictor of stress and vulnerability, and a risk factor for cardiovascular disorder (Pereira et al, 2013;Schaaf et al, 2010). Recent neuroimaging data have demonstrated the complexity of autonomic regulation which involves interactions between cortical and subcortical regions, medullary loci, and peripheral organs (Pereira et al, 2013).…”

“…It is also a predictor of stress and vulnerability, and a risk factor for cardiovascular disorder (Pereira et al, 2013;Schaaf et al, 2010). Recent neuroimaging data have demonstrated the complexity of autonomic regulation which involves interactions between cortical and subcortical regions, medullary loci, and peripheral organs (Pereira et al, 2013). Loss of hemispherical influences on autonomic modulation occurring from the brain lesion itself may result in less adaptive reserves of the autonomic cardiac regulation (Yang et al, 2002;Zamuner et al, 2011).…”

Acute and chronic psychological stress as risk factors for cardiovascular disease: Insights gained from epidemiological, clinical and experimental studies

“…In the context of cardiovascular diseases, psychological stress exposure is known to activate specific brain regions leading to the activation of the HPA axis and the sympathetic system, which can directly affect the vessel wall (for review see Pereira et al, 2013;Golbidi et al, 2015), by increasing heart rate and blood pressure, but also by causing endothelial dysfunction, which is actually one of the primary triggers for the development of atherosclerosis. Stress-mediated induction of the sympathetic nervous system and the HPA-axis results in an enhanced activation or the RAAS system, which directly results in endothelial activation and damage as indicated by increased adhesion molecule expression.…”

The role of neutrophil gelatinase associated lipocalin (NGAL) as biological constituent linking depression and cardiovascular disease

“…In addition, prospective studies with depressed individuals show that a history of major depressive episodes is associated with a higher risk of myocardial infarction, even after correction for major coronary risk factors (Pereira et al, 2013). A systemic review calculated a pooled relative risk of 1.64 for developing coronary heart disease in patients with major depression (Rugulies, 2002).…”