Acute Cerebrocardial Syndrome: What’s New?

Ischemic stroke and cardiovascular diseases have many common risk factors. Accordingly, patients with common triggers have high risk of developing brain-heart axis disorders. Since 2018, the stroke-heart syndrome has been distinguished in the cerebrocardial relationships structure. It includes any new heart disorders or worsening of existing heart diseases observed during the first 30 days after acute ischemic stroke, the peak of which occurs in the first 72 hours after the neurological catastrophe. The pathogenetic mechanisms of this syndrome are currently being actively studied. The main cause of heart damage against the background of stroke is the autonomic nervous system dysfunction, which is manifested in a decrease in parasympathetic and an increase in sympathetic activity, which is presented as a heart rate variability and baroreceptor reflex decrease. Stroke is also accompanied by the hypothalamic-pituitary-adrenal axis and the sympathoadrenal system activation, the systemic inflammatory response and hypercoagulation development. Recent data indicate that microRNA and intestinal microbiota play a role in cerebrocardial interactions. The review describes current concepts of this type of acute cerebrocardial syndrome manifestations, the classification possibilities and attempts at phenotyping, and also provides current epidemiological data. The diagnostic capabilities of routine laboratory and instrumental examinations are discussed, as well as promising methods that require additional research.

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