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Review

Brain–Heart Interaction

Cardiac Complications After Stroke

Zhili Chen, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan, Jieli Chen
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https://doi.org/10.1161/CIRCRESAHA.117.311170
Circulation Research. 2017;121:451-468
Originally published August 3, 2017
Zhili Chen
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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Poornima Venkat
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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Don Seyfried
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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Michael Chopp
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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Tao Yan
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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Jieli Chen
From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
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  • Article
    • Abstract
    • Scope of This Review
    • Cardiac Damage and Stroke in the Light of Risk Factors and Pre-Existing Heart Disease
    • Cardiac Damage as a Consequence of Stroke
    • Mechanisms of Brain–Heart Interaction After Stroke
    • Future Perspectives
    • Conclusions
    • Sources of Funding
    • Disclosures
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    • References
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Abstract

Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, that is, 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. 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 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 after stroke, such as the hypothalamic–pituitary–adrenal axis; catecholamine surge; sympathetic and parasympathetic regulation; microvesicles; microRNAs; gut microbiome, immunoresponse, and systemic inflammation, are discussed.

  • brain injury
  • brain ischemia
  • heart failure
  • inflammation
  • stroke
  • © 2017 American Heart Association, Inc.
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Circulation Research
August 4, 2017, Volume 121, Issue 4
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    • Abstract
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    • Cardiac Damage and Stroke in the Light of Risk Factors and Pre-Existing Heart Disease
    • Cardiac Damage as a Consequence of Stroke
    • Mechanisms of Brain–Heart Interaction After Stroke
    • Future Perspectives
    • Conclusions
    • Sources of Funding
    • Disclosures
    • Footnotes
    • References
  • Figures & Tables
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    Brain–Heart Interaction
    Zhili Chen, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan and Jieli Chen
    Circulation Research. 2017;121:451-468, originally published August 3, 2017
    https://doi.org/10.1161/CIRCRESAHA.117.311170

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    Brain–Heart Interaction
    Zhili Chen, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan and Jieli Chen
    Circulation Research. 2017;121:451-468, originally published August 3, 2017
    https://doi.org/10.1161/CIRCRESAHA.117.311170
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