Cardioneurology and neurocardiology are two sides of the same problem

Relevance. Cardiovascular and cerebrovascular diseases remain leading causes of disability and mortality. Recent evidence indicates a close bidirectional relationship between the heart and the brain, mediated by autonomic, neurohumoral, and inflammatory mechanisms. This interplay is conceptualized within cardioneurology and neurocardiology. Objective. Drawing on current scientific understanding of the new, interdisciplinary, and mutually complementary field of medical science known as cardioneurology/neurocardiology, this text aims to introduce the reader to the key disease entities responsible for the development of the pathological bidirectional brain–heart axis and to demonstrate the importance of an interdisciplinary approach to studying this combined pathology. Methods. A narrative review of publications from PubMed, Scopus, and eLIBRARY predominantly over the last 20 years addressing pathophysiological and clinical aspects of cardioneurological and neurocardiological interactions was performed. Results. The first part of the review examines stroke-mediated pathological alterations in cardiac functional activity (ECG changes, arrhythmias, myocardial infarction, heart failure, sudden cardiac death of neurological origin, and Takotsubo syndrome), while the second part addresses cardiac risk factors that precipitate cerebrovascular disorders (atrial fibrillation, arterial hypertension, chronic heart failure, ischemic heart disease, and cardiomyopathies, including alcoholic cardiomyopathy). Conclusion. Integrating knowledge on the ‘brain–heart’ axis creates new opportunities for developing comprehensive therapeutic approaches aimed at dual protection of both organs. Further research should focus on identifying specific biomarkers and targets for personalized therapy.