From Neurocardiology to Stroke-Heart Syndrome

Area of Science:

• Neurocardiology
• Autonomic Nervous System
• Cardiovascular Medicine

Background:

• The Stroke-Heart syndrome encompasses cardiac alterations following stroke, crucial in neurocardiology.
• Brain-heart and stroke-heart correlations are underpinned by neurophysiological studies on central autonomic system and cardiac function.
• Cardiac changes significantly impact stroke evolution and prognosis.

Purpose of the Study:

• To review the spectrum of cardiac changes within the Stroke-Heart syndrome.
• To elucidate the relationship between the central autonomic system and cardiac function post-stroke.
• To discuss neurogenic myocardial ischemia, including Takotsubo syndrome and stunned myocardium.

Main Methods:

• This narrative review synthesizes existing neurophysiological and clinical studies.
• It examines clinical, ECG, echocardiographic, and biological markers of cardiac changes.
• Focuses on the initial 30 days post-stroke onset.

Main Results:

• Stroke-Heart syndrome involves cardiac changes driven by hypothalamus-pituitary-adrenal axis activation and catecholamine release.
• Neurogenic myocardial ischemia, like Takotsubo syndrome and stunned myocardium, presents with distinct ECG and biomarker changes.
• These conditions are typically reversible but can lead to cardiac dysfunction.

Conclusions:

• The Stroke-Heart syndrome highlights the intricate connection between brain injury and cardiac events.
• Understanding brain-heart correlation offers new insights into stress cardiomyopathy and neurogenic myocardial injury.
• Early recognition and management of cardiac changes are vital for stroke patient outcomes.