The Brain–Heart Crosstalk

  • Anna Teresa MazzeoEmail author
  • Valentina Tardivo
  • Simone Cappio Borlino
  • Diego Garbossa
Part of the Physiology in Clinical Neurosciences – Brain and Spinal Cord Crosstalks book series (PNBSCC)


Acute neurocardiogenic injury is a relevant complication occurring after an acute brain injury, especially after subarachnoid haemorrhage, and is associated with an increased risk of morbidity and mortality. The cardiac involvement can be expressed as ECG anomalies (QT interval prolongation, T wave and ST segment anomalies, cardiac arrhythmias), elevation of the serum markers of cardiac injury or regional or global wall motion abnormalities resulting in different grades of heart failure, from mild dysfunction to cardiogenic shock. This cardiac dysfunction, also known as neurogenic stress cardiomyopathy, is usually reversible and functional in origin but is associated with increased morbidity and mortality. In clinical practice, acute neurocardiogenic injury is generally underdiagnosed. This chapter discusses relevant pathophysiological changes occurring at cardiac level after an acute brain injury and the clinical implications of brain–heart crosstalk.



Acute coronary syndrome


Acute ischemic stroke


Autonomic nervous system


Adrenergic receptors

AV node

Atrioventricular node


Coronary artery disease


Contraction band necrosis


Confidence interval




Central nervous system






G-protein-coupled receptor kinase 5


Hazard ratio


Intracranial haemorrhage


Left ventricle


Left ventricular ejection fraction


Nitric oxide synthase


Neurogenic stress cardiomyopathy


Neurogenic stunned myocardium


Regional wall motion abnormality

SA node

Sinoatrial node


Subarachnoid haemorrhage


Traumatic brain injury


Tumour necrosis factor


Takotsubo cardiomyopathy



This chapter has been supported by San Paolo Grant S1618_L2_MAZA_01.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Anna Teresa Mazzeo
    • 1
    • 2
    Email author
  • Valentina Tardivo
    • 3
  • Simone Cappio Borlino
    • 1
  • Diego Garbossa
    • 3
  1. 1.Division of Anesthesia and Intensive Care, Department of Surgical SciencesUniversity of TorinoTorinoItaly
  2. 2.Azienda Ospedaliera Universitaria Policlinico G. MartinoMessinaItaly
  3. 3.Neurosurgery, Department of Neurosciences and Mental HealthUniversity of TorinoTorinoItaly

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