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BHF-funded researcher Professor Svetlana Reilly and her team at the University of Oxford have recently discovered a new heart hormone – calcitonin – previously thought to only be produced by the thyroid gland. Published in Nature, the research revealed that cells in the atria (the top chambers of the heart) produce more calcitonin than cells in the thyroid. Your great vessels are similar to other blood vessels in your body. The arteries carry blood away from your heart, and the veins carry blood toward your heart. However, there’s a crucial difference. Helen Keller understood the essence of a true heart connection when she said the following: “ the most beautiful things in the world can not be seen or even touched. They must be felt with the heart.”
While the Laceys were conducting their research in psychophysiology, a small group of cardiologists joined forces with a group of neurophysiologists and neuroanatomists to explore areas of mutual interest. This represented the beginning of the new discipline now called neurocardiology. One of their early findings is that the heart has a complex neural network that is sufficiently extensive to be characterized as a brain on the heart (Figure1.2). [11, 12] The heart-brain, as it is commonly called, or intrinsic cardiac nervous system, is an intricate network of complex ganglia, neurotransmitters, proteins and support cells, the same as those of the brain in the head. The heart-brain’s neural circuitry enables it to act independently of the cranial brain to learn, remember, make decisions and even feel and sense. Descending activity from the brain in the head via the sympathetic and parasympathetic branches of the ANS is integrated into the heart’s intrinsic nervous system along with signals arising from sensory neurons in the heart that detect pressure, heart rate, heart rhythm and hormones. Bruijnzeel AW, Stam R, Croiset G, & Wiegant VM (2001). Long-term sensitization of cardiovascular stress responses after a single stressful experience. Physiol Behav, 73( 1–2), 81–86. doi:S0031-9384(01)00435-8 [pii] [ PubMed] [ Google Scholar]From my heart to yours… may your conversations be valuable and intimate, and may conflicts dissolve into understanding. There’s a way in which people with a true heart to heart connection seem to be tuned into what their partner is thinking, wanting and needing. Though it’s not possible for people to be attuned 100 % of the time, they do seem to just get each other most of the time. There are many privileges to living in the age of modern love; one of which is that most are free to choose who they want to be with. They are free to love and they are free to leave when things don’t work out.
Orexins also modulate cardiovascular functions, through both central autonomic control and peripheral actions. The extensive projections of orexin neurons to brainstem areas such as the LC and rostral ventrolateral medulla (RVLM) anatomically support their role in the central regulation of autonomic responses, especially cardiovascular responses to stress ( Carrive, 2017; Grimaldi, Silvani, Benarroch, & Cortelli, 2014) and sympathetic regulation associated with chronic hypertension ( Abreu et al., 2018). In a rat model of myocardial infarction and progressive HFrEF, a significant reduction in orexin mRNA levels was associated with the degree of cardiovascular compromise ( Hayward et al., 2015), while in an Ox2R deflicient transgenic mouse model cardiac function worsened with overstimulation of the sympathetic or angiotensin receptor pathways ( Perez et al., 2015). In human studies, a specific single nucleotide polymorphism (SNP) within the OxR2 was identified in HFrEF patients ( Perez et al., 2015). This orexin receptor gene variant was not only present in a subset of HFrEF patients using GWAS, but more importantly, those HFrEF patients appeared to be more refractory to conventional HF therapeutics. Further, higher OxA plasma levels in HFrEF patients were associated with greater functional improvements following conventional HF therapeutics when compared to HFrEF patients with low OxA plasma levels ( Ibrahim et al., 2016). These studies continue to provide support for the postulate that a relative reduction in specific bioactive signaling pathways, such as that of orexin, can potentially accelerate the HF process as well as influence response to HF therapeutics.
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Professor Gourine explains: “People with heart failure can find it very difficult to exercise, as they get out of breath easily." Carrive P (2017). Orexin, Stress and Central Cardiovascular Control. A Link with Hypertension? Neurosci Biobehav Rev, 74( Pt B), 376–392. doi: 10.1016/j.neubiorev.2016.06.044 [ PubMed] [ CrossRef] [ Google Scholar] Hayward LF, Hampton EE, Ferreira LF, Christou DD, Yoo JK, Hernandez ME, & Martin EJ (2015). Chronic heart failure alters orexin and melanin concentrating hormone but not corticotrophin releasing hormone-related gene expression in the brain of male Lewis rats. Neuropeptides, 52, 67–72. doi: 10.1016/j.npep.2015.06.001 [ PubMed] [ CrossRef] [ Google Scholar]
Inferior vena cava: This large vein delivers oxygen-poor blood from your lower body into your heart’s right atrium.
Stay In Your Heart To Speak To Others’
Does counteracting negative stressors reduce cardiovascular risk? While no clinical outcome trials have been conducted to date, adoption of lifestyle strategies aimed at improving positive emotions seems to improve biomarkers of cardiovascular health, such as inflammation, arterial stiffness, and endothelial function. In my cardiology practice and as elaborated upon below, I recommend that my patients employ these five strategies to reduce day-to-day stressors: Where the atria meet the ventricles, there is an area of special cells (called the atrio-ventricular node) which pass the electrical signals throughout your heart muscle by a system of electrical pathways, known as the conducting system. Failing brain function can impair thinking, memory, concentration, energy levels and bodily systems regulated by the brain. Stroke and dementia, including Alzheimer's disease, are some of the most serious risks of poor brain and heart health. Though it may sound cliche, I like to begin tough conversations with the words, “Let’s have a heart to heart and talk about what’s going on here.” Speaking intention aloud is powerful. And this sentence sets the tone for the discussion to follow. We know very little about exactly how exercise changes the way the brain controls the heart for the better. We’re also in the dark as to how this goes awry when people develop heart disease.
Once information has been processed by the heart’s intrinsic nervous system, the appropriate signals are sent to the heart’s sinoatrial node and to other tissues in the heart. Thus, under normal physiological conditions, the heart’s intrinsic nervous system plays an important role in much of the routine control of cardiac function, independent of the central nervous system. The heart’s intrinsic nervous system is vital for the maintenance of cardiovascular stability and efficiency and without it, the heart cannot function properly. The neural output, or messages from the intrinsic cardiac nervous system travels to the brain via ascending pathways in the both the spinal column and vagus nerves, where it travels to the medulla, hypothalamus, thalamus and amygdala and then to the cerebral cortex. [5, 16, 17] The nervous-system pathways between the heart and brain are shown in Figure 1.3 and the primary afferent pathways in the brain are shown in Figure 1.4.
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One recent study, for example, found that in a group that had practiced meditation on a regular basis, the expression of pro-inflammatory genes was reduced compared to those who had never mediated. In the second stage of the study, one half of the non-meditating group was randomly assigned to relaxation training sessions incorporating meditation, prayer, and yoga. After two months, genetic expression of pro-inflammatory genes resembled that of long-time meditators. Practicing relaxation also reduced the expression of genes promoting insulin resistance, the forerunner of Type 2 diabetes. The results of this study not only affirmed the importance of brain-heart connections on a molecular level but found that relaxation can have a robust effect in a very short time, supporting the adage “never too late to start.”
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