Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

Luciano A Sposato¹, Max J Hilz², Sara Aspberg³, Santosh B Murthy⁴, M Cecilia Bahit⁵, Cheng-Yang Hsieh⁶, Mary N Sheppard⁷, Jan F Scheitz⁸; World Stroke Organisation Brain & Heart Task Force

Affiliations

¹ Heart & Brain Laboratory, Western University, London, Ontario, Canada; Departments of Clinical Neurological Sciences, Epidemiology and Biostatistics, and Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Robarts Research Institute, London, Ontario, Canada. Electronic address: Luciano.Sposato@LHSC.on.ca.
² University of Erlangen-Nuremberg, Erlangen, Germany; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
³ Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
⁴ Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York. Electronic address: https://twitter.com/san_murthy.
⁵ INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina. Electronic address: https://twitter.com/ceciliabahit.
⁶ Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan; School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: https://twitter.com/chengyanghsieh.
⁷ Molecular and Clinical Sciences Research Institute, St George's, University of London, London, United Kingdom.
⁸ Klinik für Neurologie mit Experimenteller Neurologie and Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany; German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), partner site Berlin, Charité-Universitätsmedizin Berlin, Germany; Berlin Institute of Health, Berlin, Germany. Electronic address: https://twitter.com/Jan_FriSch.

PMID: 33272372
DOI: 10.1016/j.jacc.2020.10.009

Free article

Review

Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

Luciano A Sposato et al. J Am Coll Cardiol. 2020.

Free article

. 2020 Dec 8;76(23):2768-2785.

doi: 10.1016/j.jacc.2020.10.009.

Authors

Affiliations

¹ Heart & Brain Laboratory, Western University, London, Ontario, Canada; Departments of Clinical Neurological Sciences, Epidemiology and Biostatistics, and Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Robarts Research Institute, London, Ontario, Canada. Electronic address: Luciano.Sposato@LHSC.on.ca.
² University of Erlangen-Nuremberg, Erlangen, Germany; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
³ Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
⁴ Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York. Electronic address: https://twitter.com/san_murthy.
⁵ INECO Neurociencias Oroño, Rosario, Santa Fe, Argentina. Electronic address: https://twitter.com/ceciliabahit.
⁶ Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan; School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: https://twitter.com/chengyanghsieh.
⁷ Molecular and Clinical Sciences Research Institute, St George's, University of London, London, United Kingdom.
⁸ Klinik für Neurologie mit Experimenteller Neurologie and Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany; German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), partner site Berlin, Charité-Universitätsmedizin Berlin, Germany; Berlin Institute of Health, Berlin, Germany. Electronic address: https://twitter.com/Jan_FriSch.

PMID: 33272372
DOI: 10.1016/j.jacc.2020.10.009

Abstract

Over 1.5 million deaths worldwide are caused by neurocardiogenic syndromes. Furthermore, the consequences of deleterious brain-heart interactions are not limited to fatal complications. Cardiac arrhythmias, heart failure, and nonfatal coronary syndromes are also common. The brain-heart axis is implicated in post-stroke cardiovascular complications known as the stroke-heart syndrome, sudden cardiac death, and Takotsubo syndrome, among other neurocardiogenic syndromes. Multiple pathophysiological mechanisms with the potential to be targeted with novel therapies have been identified in the last decade. In the present state-of-the-art review, we describe recent advances in the understanding of anatomical and functional aspects of the brain-heart axis, cardiovascular complications after stroke, and a comprehensive pathophysiological model of stroke-induced cardiac injury.

Keywords: MACE; cardiovascular; inflammation; neurocardiogenic; stroke.

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Conflict of interest statement

Author Disclosures Dr. Sposato is supported by the Kathleen & Dr. Henry Barnett Research Chair in Stroke Research (Western University, London, Ontario, Canada), the Edward and Alma Saraydar Neurosciences Fund (London Health Sciences Foundation), and the Opportunities Fund of the Academic Health Sciences Center Alternative Funding Plan of the Academic Medical Organization of Southwestern Ontario; has served as a speaker and received consulting honoraria from Boehringer Ingelheim, Pfizer, Bayer, and Gore; has received research grants from Boehringer Ingelheim and Bayer; and is member of the Editorial Board of Neurology and Stroke Journals and the World Stroke Academy (Webinar platform of the World Stroke Organization). Dr. Murthy is supported by the National Institutes of Health (K23NS105948) and the Leon Levy Foundation. Dr. Bahit has served as a speaker for and received consulting honoraria from Pfizer. Dr. Scheitz has received a research grant from Corona-Stiftung, Germany. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

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Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

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Grants and funding

LinkOut - more resources

Full Text Sources

Medical