Abstract / Description
The heart and brain maintain systemic homeostasis through continuous bidirectional communication mediated by neural regulation, biochemical signaling, and mechanical transduction. Disruption of this communication is increasingly recognized as a contributor to cardiovascular, neurological, cognitive, and psychological disorders. Growing evidence indicates that autonomic imbalance, neuroimmune activation, hemodynamic disturbances, inflammation, altered interoception, and brain network remodeling can mediate cross-organ injury between the heart and brain. These mechanisms underlie a spectrum of heart-brain comorbidities, but their shared pathways, disease-specific manifestations, and integrated management strategies remain insufficiently understood. In this review, we summarize the physiological basis of heart-brain interactions, focusing on neural, biochemical, and mechanical pathways. We then discuss six representative disorders: Takotsubo syndrome, epileptic heart, stroke-heart syndrome, heart failure, cardiac dementia, and psychocardiology. For each condition, we highlight key epidemiological features, pathophysiological mechanisms, and integrated heart-brain management strategies. We also review clinical trials targeting heart-brain interactions, including autonomic modulation, biomarker monitoring, neuroimaging assessment, exercise therapy, psychological intervention, and pharmacological therapy. By integrating basic mechanisms, clinical phenotypes, and translational advances, this review provides a systematic framework for understanding heart-brain comorbidities and advancing precision heart-brain medicine.