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Neurocardiology. Physiopathological Aspects and Clinical Implications

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Neurocardiology. Physiopathological Aspects and Clinical Implications BOOK REVIEW Neurocardiology. Physiopathological aspects and clinical implications by Ricardo J. Gelpi and Bruno Buchholz. @ 2018 Elsevier, Spain, S: L: U; ISBN: 978-84-9113-155-7; eISBN 978-84-9113-203-5 “Books are the quietest and most constant of friends; they that 4,128 of these works date from the last 5 years (3). are the most accessible and wisest of counselors, As the authors point out, Neurocardiology. Physio- and the most patient of teachers.” pathological aspects and clinical implications, is the CHARLES W. E LIOT (1834-1926) first book in Spanish that provides a global view on this specialty, ranging from basic aspects to clinical “I always imagined paradise as a kind of library” manifestations, making it a comprehensive resource JORGE L. BORGES (1899-1986) of great value for this emerging discipline. This book is addressed to researchers, residents and physicians trained in cardiology, neurology, internal Medicine, in- Neurocardiology. Pathophysiological aspects and clini- tensive care medicine, anesthesiology, cardiovascular cal implications, a book by Ricardo J. Gelpi and Bruno surgery and neurosurgery, It will also be of interest to Buchholz, published in 2018, is presented in a volume professionals from other related areas. “ of 365 pages and 20 color illustrations. Sixty-five coau- The work is organized in 29 chapters. The first is thors of national and international relevance collabo- introductory and refers to the history of neurocardiol- rated in its edition. ogy. Chapters 2 to 8 analyze anatomical, physiological As pointed out by Benjamin Natelson more than and physiopathological aspects of the brain-heart re- 30 years ago (1), “neurocardiology is the study of the lationship under the following titles: functional neu- neurophysiological, neurological and neuroanatomical roanatomy of the heart, intrinsic neuroanatomy of aspects of cardiology, especially including the neuro- the human heart and other mammals, hypothalamic logical origins of cardiac disorders.” More recently, Os- control of cardiovascular function, parasympathetic teraas and Lee (2) highlighted the clinical implications control of cardiac function: a new target of therapeu- of the nervous system interaction with the cardiovas- tic opportunities, molecular mechanisms involved in cular system: the regulation of cardiac adrenergic and cholinergic “Cardiomyopathy due to stress exemplifies the signals, chronobiology of cardiovascular function, brain-heart connection and occurs in several condi- and heart rate variability, its mechanisms and its re- tions with acute brain lesions that share excessive lationship with autonomic innervation. Chapters 9 sympathetic activation. The brain influences on the to 28 are particularly devoted to the clinical aspects heart include elevation of cardiac markers, arrhyth- of neurocardiology: physiopathology of vasovagal mias, repolarization disorders in the electrocardio- syncope, syncope with autonomic nervous system gram, myocardial necrosis and autonomic dysfunc- participation, neural regulation in heart failure, neu- tion. The neurogenic stunned myocardium following rohumoral interaction in heart failure control, car- aneurysmal subarachnoid hemorrhage represents one diovascular control during exercise in heart failure, end of the spectrum, and is associated with a marked autonomic control in acute myocardial infarction: ef- increase of intracranial pressure that results in the fects of vagal stimulation, autonomic modulation for exaggerated increase of catecholamines and possibly, the management of patients with chronic heart fail- necrosis, with contraction bands.” ure, participation of the autonomic nervous system The increase in scientific works related with neuro- in myocardial protection mechanisms, neuromodu- cardiology testifies the current interest and relevance lation in chronic refractory cardiac pain, autonomic of neurocardiology. Effectively, up to the time of this nervous system and its importance in the genesis of review we found 5,710 works cited in Pubmed that in- cardiac arrhythmias, sudden death and autonomic clude the term “neurocardiology”. More interesting is nervous system, cardiac autonomic innervation and REV ARGENT CARDIOL 2019;87:66-67 - http://dx.doi.org/10.7775/rac.v87.i1.146361 67 role of neuromodulatory treatments, trigeminocar- both in its modern design and layout as s in the quality diac reflex, cardiovascular autonomic neuropathy in of its printing and binding. diabetes mellitus, cardiovascular diseases in neuro- As readers attentive to the advances of cardiology logical diseases: Parkinson’s disease, neurocardiology from its basic aspects to its clinical applications, we and cerebrovascular disease, dysautonomic arrhyth- recognize the enormous value of this book, and thank mogenesis: a working hypothesis in chagasic heart Drs. Ricardo J. Gelpi and Bruno Buchholz, as well as disease, autonomic cardiovascular regulation in sleep the co-authors for the idea and achievement of this apnea, Takotsubo syndrome or stress cardiomyopa- book. We celebrate the possibility of having a work thy, and cardiac interoception as a regulating mecha- that will certainly enrich our understanding and inter- nism of behaviors and emotions. The last chapter is est in an area of great importance and relevance. a corollary worthy of the work since it exposes the future of Neurocardiology through the lens of the Daniel José Piñeiro polyvagal theory. Professor of Medicine The Elsevier edition is extremely neat and careful, University of Buenos Aires.
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