Stroke-heart syndrome: clinical presentation and underlying mechanisms

Area of Science:

• Cardiology
• Neurology
• Neuroscience

Background:

• Cardiac complications frequently occur within days of ischaemic stroke, manifesting as myocardial injury, cardiac dysfunction, and arrhythmia.
• These cardiac disturbances are believed to stem from shared pathophysiological mechanisms.
• Emerging evidence points to stroke-induced alterations in the central autonomic network as the primary driver.

Purpose of the Study:

• To define and consolidate the understanding of stroke-associated cardiac alterations.
• To highlight the link between central autonomic dysregulation and cardiac events post-stroke.
• To emphasize the need for further research into long-term consequences and therapeutic targets for stroke-heart syndrome.

Main Methods:

• Review of clinical and neuroimaging studies.
• Analysis of animal research findings.
• Synthesis of evidence on the pathophysiology of stroke-heart syndrome.

Main Results:

• Stroke-induced central autonomic network alterations lead to dysregulated neural cardiac control.
• This dysregulation can precipitate myocardial necrosis, microvascular dysfunction, ischaemia, and arrhythmias.
• Stroke-heart syndrome is associated with poor short-term prognosis.

Conclusions:

• Stroke-heart syndrome represents a distinct clinical entity linking neurological and cardiac events.
• Further investigation is crucial to elucidate long-term outcomes and identify specific therapeutic strategies.
• An integrated understanding of stroke-heart syndrome is essential for advancing research and clinical practice.