Cardiovascular pathophysiology from the cardioneural perspective and its clinical applications

Coronary heart disease and psychological stress factors such as depression are prevalent and associated with high morbidity/mortality; they are also challenging to manage, especially when treated in isolation of each other. Recent advances support an integrated approach to their management that is built on a foundation of an extensive, multi-component network of neurological structures. In this review, we de-scribe this extensive cardioneural network that encompasses the heart, brain, spinal cord, and ganglia throughout the body, and then discuss ambulatory and laboratory-based non-invasive measures of this network that both measure psychological stress and heart disease severity. Lastly, we discuss their po-tential transformative clinical and public health applications, and also possible cardioneural interventions such as exercise and biofeedback. (c) 2021 Elsevier Inc. All rights reserved.

Automated summary

Coronary heart disease and psychological stress factors like depression are highly prevalent and difficult to manage. Recent research suggests that adopting an integrated approach to managing the heart and neurological network may be effective. This article describes an extensive cardioneural network that includes the heart, brain, spinal cord, and ganglia throughout the body, and discusses non-invasive measures that can assess both psychological stress and severity of heart disease. Finally, the article explores the potential clinical and public health applications of these measures and potential cardioneural interventions.