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Potential clinical relevance of the “little brain” on the mammalian heart
Open accessAbstract
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 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]
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Metadata
- 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
- 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
- bronze
- doi.org
- 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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