Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

Luciano A Sposato; Max J Hilz; Sara Aspberg; Santosh B Murthy; M Cecilia Bahit; Cheng-Yang Hsieh; Mary N Sheppard; Jan F Scheitz; World Stroke Organisation Brain & Heart Task Force

doi:10.1016/j.jacc.2020.10.009

Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

J Am Coll Cardiol. 2020 Dec 8;76(23):2768-2785. doi: 10.1016/j.jacc.2020.10.009.

Authors

Luciano A Sposato¹, Max J Hilz², Sara Aspberg³, Santosh B Murthy⁴, M Cecilia Bahit⁵, Cheng-Yang Hsieh⁶, Mary N Sheppard⁷, Jan F Scheitz⁸; World Stroke Organisation Brain & Heart Task Force

Affiliations

¹ Heart & Brain Laboratory, Western University, London, Ontario, Canada; Departments of Clinical Neurological Sciences, Epidemiology and Biostatistics, and Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Robarts Research Institute, London, Ontario, Canada. Electronic address: Luciano.Sposato@LHSC.on.ca.
² University of Erlangen-Nuremberg, Erlangen, Germany; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
³ Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
⁴ Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York. Electronic address: https://twitter.com/san_murthy.
⁵ INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina. Electronic address: https://twitter.com/ceciliabahit.
⁶ Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan; School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: https://twitter.com/chengyanghsieh.
⁷ Molecular and Clinical Sciences Research Institute, St George's, University of London, London, United Kingdom.
⁸ Klinik für Neurologie mit Experimenteller Neurologie and Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany; German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), partner site Berlin, Charité-Universitätsmedizin Berlin, Germany; Berlin Institute of Health, Berlin, Germany. Electronic address: https://twitter.com/Jan_FriSch.

PMID: 33272372
DOI: 10.1016/j.jacc.2020.10.009

Abstract

Over 1.5 million deaths worldwide are caused by neurocardiogenic syndromes. Furthermore, the consequences of deleterious brain-heart interactions are not limited to fatal complications. Cardiac arrhythmias, heart failure, and nonfatal coronary syndromes are also common. The brain-heart axis is implicated in post-stroke cardiovascular complications known as the stroke-heart syndrome, sudden cardiac death, and Takotsubo syndrome, among other neurocardiogenic syndromes. Multiple pathophysiological mechanisms with the potential to be targeted with novel therapies have been identified in the last decade. In the present state-of-the-art review, we describe recent advances in the understanding of anatomical and functional aspects of the brain-heart axis, cardiovascular complications after stroke, and a comprehensive pathophysiological model of stroke-induced cardiac injury.

Keywords: MACE; cardiovascular; inflammation; neurocardiogenic; stroke.

Publication types

Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Autonomic Nervous System / physiopathology*
Heart Diseases / etiology*
Humans
Stroke / complications*
Stroke / physiopathology*

Grants and funding

K23 NS105948/NS/NINDS NIH HHS/United States