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The Cardiorenal Cross Talk

The Autonomic Pathway Regulating the Cardiocirculatory Balance

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Brain and Heart Dynamics

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Abstract

The autonomic nervous system (ANS) controls essential physiologic functions, including heart rate, blood pressure, and body fluid volume regulation [1]. It is now well understood that the ANS is specifically designed to maintain body homeostasis eliciting organ-specific responses in the face of external challenges [2]. This complex task is accomplished by continuous and instantaneous interactions of its two limbs: the sympathetic and parasympathetic ones. As a matter of fact, the so-called sympatho-vagal interaction is the key mechanism able to warrant all needed adjustments to any aspect of the physiological activity of the entire body. Any alteration or maladaptive response of the ANS to physiological or pathological events (from simple position changes to compensatory responses to acute myocardial ischemia, for instance) results in disease development or progression. Specific to the cardio-renal axis is the fact that congestion due to intravascular overload is the most potent driver of sympathetic nervous system activation that increases arterial vascular resistance and organ hypoperfusion. In this context, kidneys are severely blood supply deprived and react to the higher intra-parenchimal vascular resistance by increasing the sympathetic response and the neuro-hormonal activation, with major consequence in fluid retention. The overall effect worsens heart function and target organs damage contributing to maintain and to aggravate heart failure progression.

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Author information

Authors and Affiliations

  1. Dept Medicina e Specialità Mediche – Nephrology Section, IRCCS Cà Granda Policlinico di Milano, Milan, Italy

    Edoardo Gronda

  2. Department of Molecular Medicine, University of Pavia, Pavia, Italy

    Emilio Vanoli

  3. Cardiovascular Department IRCCS MultiMedica, Sesto San Giovanni, Italy

    Emilio Vanoli

Authors
  1. Edoardo Gronda
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  2. Emilio Vanoli
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Corresponding author

Correspondence to Edoardo Gronda .

Editor information

Editors and Affiliations

  1. Dept of Drug Sciences, Pharmacology Sect, University of Pavia, Dept of Drug Sciences, Pharmacology Sect, Pavia, Pavia, Italy

    Stefano Govoni

  2. Dept of Brain and Behavioural Sciences, University of Pavia Dept of Brain and Behavioural Sciences, Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Department of Molecular Medicine, Pavia, Pavia, Italy

    Emilio Vanoli

Section Editor information

  1. Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy

    Alessia Pascale

  2. Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy

    Emilia d’Elia

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Gronda, E., Vanoli, E. (2019). The Cardiorenal Cross Talk. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-319-90305-7_3-1

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  • DOI: https://doi.org/10.1007/978-3-319-90305-7_3-1

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  • Print ISBN: 978-3-319-90305-7

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