title: Asymmetric sympathetic output: The dorsomedial hypothalamus as a potential link between emotional stress and cardiac arrhythmias.
abstract: The autonomic response to emotional stress, while involving several target organs, includes an important increase in sympathetic drive to the heart. There is ample evidence that cardiac sympathetic innervation is lateralized, and asymmetric autonomic output to the heart during stress is postulated to be a causal factor that precipitates cardiac arrhythmias. Recent animal studies provided a new picture of the central pathways involved in the cardiac sympathetic response evoked by emotional stress, pointing out a key role for the region of dorsomedial hypothalamus. However, how much of this information can be extrapolated to humans? Analysis of human functional imaging data at rest or during emotional stress shows some consistency with the components that integrate these pathways, and attention must be given to the asymmetric activation of subcortical sites. In this short review, we will discuss related findings in humans and animals, aiming to understand the neurogenic background for the origin of emotional stress-induced cardiac arrhythmias.
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: peliky@icb.ufmg.br.
authors.forename: Marco Antônio Peliky
authors.initials: MAP
authors.lastname: Fontes
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Marcelo Limborço
authors.initials: ML
authors.lastname: Filho
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Natália L
authors.initials: NL
authors.lastname: Santos Machado
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Cristiane Amorim
authors.initials: CA
authors.lastname: de Paula
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Letícia M
authors.initials: LM
authors.lastname: Souza Cordeiro
authors.affiliation: Departamento de Ciências Fisiológicas, Universidade Federal de Goiás, Goiânia, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Xavier
authors.affiliation: Departamento de Fisiologia e Biofísica, INCT, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fernanda Ribeiro
authors.initials: FR
authors.lastname: Marins
authors.affiliation: Department of Anatomy & Histology, University of Sydney, Sydney, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Henderson
authors.affiliation: School of Medicine, University of Western Sydney, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
authors.forename: Vaughan G
authors.initials: VG
authors.lastname: Macefield
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
keywords: Brain asymmetry; Brain imaging; Cardiac arrhythmia; Emotional stress; Sympathetic activity