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Review
. 2024 Mar 15:156:190-200.
doi: 10.1016/j.semcdb.2023.01.001. Epub 2023 Jan 12.

The vagus nerve in cardiovascular physiology and pathophysiology: From evolutionary insights to clinical medicine

Pradeep S Rajendran  1 , Joseph Hadaya  2 , Sahib S Khalsa  3 , Chuyue Yu  4 , Rui Chang  4 , Kalyanam Shivkumar  5
Affiliations
Review

The vagus nerve in cardiovascular physiology and pathophysiology: From evolutionary insights to clinical medicine

Pradeep S Rajendran et al. Semin Cell Dev Biol. .

Abstract

The parasympathetic nervous system via the vagus nerve exerts profound influence over the heart. Together with the sympathetic nervous system, the parasympathetic nervous system is responsible for fine-tuned regulation of all aspects of cardiovascular function, including heart rate, rhythm, contractility, and blood pressure. In this review, we highlight vagal efferent and afferent innervation of the heart, with a focus on insights from comparative biology and advances in understanding the molecular and genetic diversity of vagal neurons, as well as interoception, parasympathetic dysfunction in heart disease, and the therapeutic potential of targeting the parasympathetic nervous system in cardiovascular disease.

Keywords: Cardiovascular disease; Cardiovascular physiology; Interoception; Neuromodulation; Vagus nerve.

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Conflict of interest statement

Conflict of Interest

Pradeep Rajendran and Kalyanam Shivkumar are co-founders of NeuCures, Inc. University of California, Los Angeles has patents developed by Kalyanam Shivkumar relating to cardiac neural diagnostics and therapeutics

Figures

Figure 1.
Figure 1.. Parasympathetic innervation of the heart and therapies targeting the parasympathetic nervous system for treatment of cardiovascular diseases.
(Left) Parasympathetic preganglionic neurons innervating the heart originate in the medulla of the brainstem (top) and project via the vagus nerve to ganglionated plexi of the intrinsic cardiac nervous system (bottom). Postganglionic neurons in ganglionated plexi then project to atrial and ventricular myocardial tissue, the conduction system, and the vasculature. Vagal afferent neurons have cell bodies in the superior and inferior ganglia of the vagus and project to the medulla. (Right) The parasympathetic nervous system is being targeted at level of the auricular branch of the vagus nerve, which innervates the tragus of the external ear (top), the cervical vagus nerve (middle), and ganglionated plexi (bottom) for a variety of cardiovascular disease states including heart failure and arrhythmias.
See this image and copyright information in PMC

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