2006 Heart-Brain summit proceedings
Subarachnoid hemorrhage:
A model for heart-brain interactions
ARTICLE INTRODUCTION
Research on the brain-heart connection has traditionally focused on intentionally altering the brain and observing the effect on the heart, but natural brain injury also confers a specific signal to the heart and causes observable effects. Subarachnoid hemorrhage serves as a good model for how brain injury affects the heart because it causes characteristic cardiac responses, including arrhythmias, contraction band necrosis, and ischemia-like changes.
This article summarizes research relating to the cardiac effects of subarachnoid hemorrhage, proposes a physiologic model of how brain injury leads to cardiac damage, and suggests future directions for research.
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Clinical significance FIGURE 2. A new model of heart-brain interaction based on combined sympathetic hyperactivity and parasympathetic dysfunction (shaded area).
Brain injury
Myocardial cell death
Arrhythmia
Insular cortex involved Hypothalamic
pressure
Catecholamine release
ATP depletion
MPT activation
Parasympathetic dysfunction
Unchecked inflammation
Myocardial dysfunction
ATP = adenosine triphosphate
MPT = mitochondrial permeability transition of elevated troponin I levels in patients with nontraumatic subarachnoid hemorrhage.
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