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The Brain–Heart Crosstalk

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Brain and Heart Crosstalk

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Abstract

Acute neurocardiogenic injury is a relevant complication occurring after an acute brain injury, especially after subarachnoid haemorrhage, and is associated with an increased risk of morbidity and mortality. The cardiac involvement can be expressed as ECG anomalies (QT interval prolongation, T wave and ST segment anomalies, cardiac arrhythmias), elevation of the serum markers of cardiac injury or regional or global wall motion abnormalities resulting in different grades of heart failure, from mild dysfunction to cardiogenic shock. This cardiac dysfunction, also known as neurogenic stress cardiomyopathy, is usually reversible and functional in origin but is associated with increased morbidity and mortality. In clinical practice, acute neurocardiogenic injury is generally underdiagnosed. This chapter discusses relevant pathophysiological changes occurring at cardiac level after an acute brain injury and the clinical implications of brain–heart crosstalk.

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Abbreviations

ACS:

Acute coronary syndrome

AIS:

Acute ischemic stroke

ANS:

Autonomic nervous system

ARs:

Adrenergic receptors

AV node:

Atrioventricular node

CAD:

Coronary artery disease

CBN:

Contraction band necrosis

CI:

Confidence interval

CM:

Cardiomyopathy

CNS:

Central nervous system

COMT:

Catechol-O-methyl-transferase

ECG:

Electrocardiogram

GRK5:

G-protein-coupled receptor kinase 5

HR:

Hazard ratio

ICH:

Intracranial haemorrhage

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

NOS:

Nitric oxide synthase

NSC:

Neurogenic stress cardiomyopathy

NSM:

Neurogenic stunned myocardium

RWMA:

Regional wall motion abnormality

SA node:

Sinoatrial node

SAH:

Subarachnoid haemorrhage

TBI:

Traumatic brain injury

TNF:

Tumour necrosis factor

TTC:

Takotsubo cardiomyopathy

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Acknowledgement

This chapter has been supported by San Paolo Grant S1618_L2_MAZA_01.

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Authors and Affiliations

  1. Division of Anesthesia and Intensive Care, Department of Surgical Sciences, University of Torino, Torino, Italy

    Anna Teresa Mazzeo & Simone Cappio Borlino

  2. Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy

    Anna Teresa Mazzeo

  3. Neurosurgery, Department of Neurosciences and Mental Health, University of Torino, Torino, Italy

    Valentina Tardivo & Diego Garbossa

Authors
  1. Anna Teresa Mazzeo
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  2. Valentina Tardivo
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  3. Simone Cappio Borlino
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  4. Diego Garbossa
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Correspondence to Anna Teresa Mazzeo .

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Editors and Affiliations

  1. Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India

    Hemanshu Prabhakar

  2. Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India

    Indu Kapoor

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Mazzeo, A.T., Tardivo, V., Cappio Borlino, S., Garbossa, D. (2020). The Brain–Heart Crosstalk. In: Prabhakar, H., Kapoor, I. (eds) Brain and Heart Crosstalk. Physiology in Clinical Neurosciences – Brain and Spinal Cord Crosstalks. Springer, Singapore. https://doi.org/10.1007/978-981-15-2497-4_3

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