Brain-Heart Interaction: Cardiac Complications After Stroke.
Brain-Heart Interaction: Cardiac Complications After Stroke.
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脑心相互作用：中风后的心脏并发症
DOI：
10.1161/circresaha.117.311170
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发表时间：
2017-08-04
影响因子：
20.1
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Chen Z;Venkat P;Seyfried D;Chopp M;Yan T;Chen J
神经心脏病学是一门新兴专业，研究大脑和心脏之间的相互作用，即心脏损伤对大脑的影响，以及脑损伤对心脏的影响。这篇综述文章重点关注缺血性中风、脑出血和蛛网膜下腔出血（SAH）等中风情况下的心脏功能障碍。大多数中风后死亡归因于神经损伤，心血管并发症是中风后死亡的第二大原因。积累的临床和实验证据表明脑损伤和心脏功能障碍之间存在因果关系。因此，确定心功能障碍是否是由中风引发、是无关的并发症还是中风的根本原因非常重要。中风引起的心脏损伤可能导致死亡或潜在的终生心脏问题（例如心力衰竭），或导致轻微且可恢复的损伤，例如神经源性应激性心肌病（NSC）和Takotsubo心肌病。中风后脑部病变的位置和偏侧化在脑-心相互作用中的作用、心脏并发症的临床生物标志物和表现，以及中风后脑-心相互作用的潜在机制，例如：下丘脑垂体肾上腺轴（HPA）；儿茶酚胺激增；交感神经和副交感神经的调节；微泡（MV）；微小RNA；讨论了肠道微生物组、免疫反应和全身炎症。
Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, i.e. the effects of cardiac injury on the brain, and the effects of brain injury on the heart. This review article focuses on cardiac dysfunction in the setting of stroke such as ischemic stroke, brain hemorrhage and subarachnoid hemorrhage (SAH). The majority of post stroke deaths are attributed to neurological damage, and cardiovascular complications are the second leading cause of post stroke mortality. Accumulating clinical and experimental evidence suggests a causal relationship between brain damage and heart dysfunction. Thus, it is important to determine whether cardiac dysfunction is triggered by stroke, is an unrelated complication, or is the underlying cause of stroke. Stroke induced cardiac damage may lead to fatality or potentially lifelong cardiac problems (such as heart failure), or to mild and recoverable damage such as neurogenic stress cardiomyopathy (NSC) and Takotsubo cardiomyopathy. The role of location and lateralization of brain lesions after stroke in brain-heart interaction, clinical biomarkers and manifestations of cardiac complications, and underlying mechanisms of brain-heart interaction following stroke, such as: the hypothalamic pituitary adrenal axis (HPA); catecholamine surge; sympathetic and parasympathetic regulation; microvesicles (MV’s); microRNAs; gut microbiome, immunoresponse and systemic inflammation are discussed.