Stroke Related Brain-Heart Crosstalk: Pathophysiology, Clinical Implications, and Underlying Mechanisms

Area of Science:

• Neuroscience
• Cardiology
• Pathophysiology

Background:

• Acute ischemic stroke (AIS) significantly impacts cardiovascular function, leading to a range of complications like heart attack and heart failure.
• The brain-heart axis describes the bidirectional communication between the central nervous system and the cardiovascular system, crucial in stroke outcomes.
• Understanding this interaction is vital for improving patient prognosis and reducing mortality.

Purpose of the Study:

• To review the current understanding of pathophysiological mechanisms linking AIS and cardiovascular dysfunctions.
• To explore the role of the brain-heart axis in stroke-related cardiac complications.
• To suggest management strategies for these dysfunctions.

Main Methods:

• Review of preclinical and clinical research on AIS-induced cardiovascular dysfunctions.
• Analysis of neurohumoral pathways, including the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system, and inflammatory responses.
• Examination of existing therapeutic interventions and their limitations.

Main Results:

• AIS triggers cardiovascular complications through mechanisms involving the HPA axis, sympathetic/parasympathetic imbalance, inflammation, and gut dysbiosis.
• These factors collectively influence the stroke-related brain-heart axis, contributing to adverse cardiac events.
• Current treatments for hypertension and arrhythmias show limitations, with therapeutic targets remaining elusive.

Conclusions:

• The brain-heart axis plays a critical role in cardiovascular complications following AIS.
• Further research is needed to identify effective therapeutic targets for managing these complex interactions.
• A comprehensive understanding of these mechanisms is essential for developing novel treatment strategies.