The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy-A Review.

Ziaka, Mairi; Exadaktylos, Aristomenis (2023). The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy-A Review. Journal of stroke, 25(1), pp. 39-54. Korean Stroke Society 10.5853/jos.2022.02173

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In recent years, it has been convincingly demonstrated that acute brain injury may cause severe cardiac complications-such as neurogenic stress cardiomyopathy (NSC), a specific form of takotsubo cardiomyopathy. The pathophysiology of these brain-heart interactions is complex and involves sympathetic hyperactivity, activation of the hypothalamic-pituitary-adrenal axis, as well as immune and inflammatory pathways. There have been great strides in our understanding of the axis from the brain to the heart in patients with isolated acute brain injury and more specifically in patients with stroke. On the other hand, in patients with NSC, research has mainly focused on hemodynamic dysfunction due to arrhythmias, regional wall motion abnormality, or left ventricular hypokinesia that leads to impaired cerebral perfusion pressure. Comparatively little is known about the underlying secondary and delayed cerebral complications. The aim of the present review is to describe the stroke-heart-brain axis and highlight the main pathophysiological mechanisms leading to secondary and delayed cerebral injury in patients with concurrent hemorrhagic or ischemic stroke and NSC as well as to identify further areas of research that could potentially improve outcomes in this specific patient population.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2287-6405

Publisher:

Korean Stroke Society

Language:

English

Submitter:

Pubmed Import

Date Deposited:

10 Jan 2023 10:16

Last Modified:

08 Feb 2023 00:15

Publisher DOI:

10.5853/jos.2022.02173

PubMed ID:

36592971

Uncontrolled Keywords:

Blood-brain barrier Neurogenic stress cardiomyopathy Neuroinflammation Stroke Stroke-heart-brain interactions Takotsubo cardiomyopathy

BORIS DOI:

10.48350/176761

URI:

https://boris.unibe.ch/id/eprint/176761

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