Brain‑heart axis: Neurostimulation techniques in ischemic heart disease (Review)

Abstract

Ischemic heart disease (IHD), mainly due to athero‑ sclerosis and coronary microvascular dysfunction, continues to be a major cause of mortality worldwide. This condition can escalate to severe complications, including heart failure, arrhythmias and sudden cardiac mortality. In advanced stages, treatments such as coronary artery bypass grafting or percuta‑ neous coronary intervention may be necessary. The brain‑heart axis, which facilitates the interaction between the central nervous system and the cardiovascular system via the auto‑ nomic nervous system, is crucial in the management of IHD. An imbalance in autonomic function, marked by increased sympathetic activity and diminished parasympathetic influence, can worsen cardiovascular conditions by promoting inflamma‑ tion, vasoconstriction and myocardial ischemia. Innovative treatments such as spinal cord stimulation and vagus nerve stimulation show potential in re‑establishing autonomic equi‑ librium and improving cardiovascular function by influencing the neurocardiac interface. The present review discussed the pathophysiology of IHD and methodically examined the role of the nervous system in this disease. It emphasized the possi‑ bilities of neural modulation therapy, while identifying ongoing challenges and areas lacking in current knowledge.