Neurocardiology and the Bidirectional Brain-Heart Axis: Modern Concepts in Neurocardiovascular Physiology

The human brain and cardiovascular system are intimately interrelated through neural, hormonal, autonomic and inflammatory communication pathways. Emerging in the scientific literature, neurocardiology is a discipline centred around the bidirectional communication between the brain and heart, known as the brain-heart axis. Contemporary advancements in neurophysiology, cardiovascular physiology, neuroimaging, artificial intelligence and wearable technology have enabled an enhanced comprehension of brain-heart relationships. Emotional distress, autonomic dysfunction, neuroinflammation, sleep disorders and lifestyle are significantly impactful on cardiovascular function; while cardiovascular disease has negative effects on cerebral circulation and neural systems. Physiological markers for brain-heart communication include heart rate variability, vagal tone and autonomic balance, along with the newest concepts such as neurocardiovascular synchrony and network physiology, along with digital biomarkers, in the new paradigm of physiology. Here we review modern concepts in neurocardiology, including the brain-heart axis anatomical and physiological structure, neurocardiovascular regulation and dysfunction, digital health monitoring, and the prospects in future studies. Understanding of brain-heart interactions may have crucial implications for the development of personalised medicine and novel therapies for neurological and cardiovascular disorders.