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Cited by 417Heart Rate Variability and Autonomic ControlCardiac electrophysiology and arrhythmiasNeuroscience of respiration and sleep

Potential clinical relevance of the “little brain” on the mammalian heart

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Armour, J. A.·2008·Experimental Physiology
DOI 10.1113/expphysiol.2007.041178
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Abstract

It is hypothetized that the heart possesses a nervous system intrinsic to it that represents the final relay station for the co‐ordination of regional cardiac indices. This ‘little brain’ on the heart is comprised of spatially distributed sensory (afferent), interconnecting (local circuit) and motor (adrenergic and cholinergic efferent) neurones that communicate with others in intrathoracic extracardiac ganglia, all under the tonic influence of central neuronal command and circulating catecholamines. Neurones residing from the level of the heart to the insular cortex form temporally dependent reflexes that control overlapping, spatially determined cardiac indices. The emergent properties that most of its components display depend primarily on sensory transduction of the cardiovascular milieu. It is further hypothesized that the stochastic nature of such neuronal interactions represents a stabilizing feature that matches cardiac output to normal corporal blood flow demands. Thus, with regard to cardiac disease states, one must consider not only cardiac myocyte dysfunction but also the fact that components within this neuroaxis may interact abnormally to alter myocyte function. This review emphasizes the stochastic behaviour displayed by most peripheral cardiac neurones, which appears to be a consequence of their predominant cardiac chemosensory inputs, as well as their complex functional interconnectivity. Despite our limited understanding of the whole, current data indicate that the emergent properties displayed by most neurones comprising the cardiac neuroaxis will have to be taken into consideration when contemplating the targeting of its individual components if predictable, long‐term therapeutic benefits are to accrue.

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  • The usefulness of MCG for better understanding arrhythmogenic mechanisms underlying high-risk J syndromes, identification of atrial arrhythmogenic vulnerability, left atrial dysfunction, atrial propagation pathways, and dominant frequencies in atrial fibrillation, as well as accurate pre-interventional 3D localization of arrhythmogenic substrates, has been widely reported.

    “The usefulness of MCG for a better understanding of the arrhythmogenic mechanisms underlying the high-risk J syndromes (225, 327–336); the identification of atrial arrhythmogenic vulnerability (248), of left atrial dysfunction (330), and of the atrial propagation pathways (228); and the dominant frequencies (181, 183, 189, 232) in patients with atrial fibrillation, as well as providing accurate”

    From Clinical magnetocardiography: the unshielded bet—past, present, and future (2023) · cites this paper as [328]

    The passages on arrhythmias and cardiac neuronal control (Implications of a primarily stochastic cardiac control system; Perspectives, page unavailable) do not discuss MCG. Searches for magnetocardiography, J syndromes, dominant frequencies, and 3D localization found no passage addressing the claimed uses of MCG. (LLM, conf=0.76)

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Research works printed but not linked: 5

  1. Ardell JL (1994). Structure and function of mammalian intrinsic cardiac neurons. In Neurocardiology, ed. Armour JA & Ardell JL, pp. 95-114. Oxford University Press, New York.
  2. Brodde O-E & Zerkowski H-R (1994). Neural control of cardiac myocyte function. In Neurocardiology, ed. Armour JA & Ardell JL, pp. 193-218. Oxford University Press, New York.
  3. Hillarp N-A (1960). Peripheral autonomic mechanisms. In Handbook of Physiology, Section I, Neurophysiology, ed. Field J, pp. 979-1006. American Physiological Society, Washington.
  4. Oppenheimer SM & Hopkins DA (1994). Suprabulbar neuronal regulation of the heart. In Neurocardiology, ed. Armour JA & Ardell JL, pp. 309-342. Oxford University Press, New York.
  5. Randall WC, Wurster RD, Randall DC & Xi-Moy SX (1996). From cardioaccelerator and inhibitory nerves to a heart brain: an evolution of concepts. In Nervous Control of the Heart, ed. Shepherd JT & Vainer SF, pp. 173-200.

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Authors
Armour, J. A.
Affiliations
Hôpital du Sacré-Cœur de Montréal (CA)
Corresponding author
Armour, J. A.
Venue
Experimental Physiology
Publisher
Wiley
Published
2008-01-16
Volume
93
Issue
2
Pages
165-176
ISSN
  • 0958-0670 (ISSN-L)
  • 1469-445X
DOI
10.1113/expphysiol.2007.041178
OpenAlex
W2153526423
Cited by
417
References
104
Citations by year
2026: 28 · 2025: 31 · 2024: 21 · 2023: 38 · 2022: 15 · 2021: 28 · 2020: 34 · 2019: 28 · 2018: 20 · 2017: 33 · 2016: 26 · 2015: 20 · 2014: 16 · 2013: 25 · 2012: 14
FWCI
1.16
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Experimental Physiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
cardiac nervous system, cardiac ganglia, catecholamines, cardiac output regulation, heart disease, emergent properties
MeSH terms
Animals, Autonomic Nervous System, Heart, Humans, Mammals, Neural Pathways, Neurons

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