title: Neurocardiology: Structure-Based Function.
abstract: Cardiac control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis. This control system is optimized to respond to normal physiological stressors (standing, exercise, and temperature); however, it can be catastrophically disrupted by pathological events such as myocardial ischemia. In fact, it is now recognized that autonomic dysregulation is central to the evolution of heart failure and arrhythmias. Autonomic regulation therapy is an emerging modality in the management of acute and chronic cardiac pathologies. Neuromodulation-based approaches that target select nexus points of this hierarchy for cardiac control offer unique opportunities to positively affect therapeutic outcomes via improved efficacy of cardiovascular reflex control. As such, understanding the anatomical and physiological basis for such control is necessary to implement effectively novel neuromodulation therapies. © 2016 American Physiological Society. Compr Physiol 6:1635-1653, 2016.
authors: Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.|UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA.
authors: Jeffrey L
authors: JL
authors: Ardell
authors: Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.|UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA.
authors: John Andrew
authors: JA
authors: Armour
mesh_terms: D000818:Animals; D004599:Electric Stimulation Therapy; D006321:Heart / Q000294:innervation*; D006801:Humans; D009046:Motor Neurons / Q000502:physiology; D009475:Neurons, Afferent / Q000502:physiology; D017933:Peripheral Nervous System