Cardiac Sympathetic-Parasympathetic Interaction: The Endless Story of Yin and Yang

Author: Veronica Dusi1, Gaetano Maria De Ferrari2, Douglas L Mann3
1 Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
2 Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy.
3 Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
Conference/Journal: JACC Basic Transl Sci
Date published: 2020 Aug 24
Other: Volume ID: 5 , Issue ID: 8 , Pages: 811-814 , Special Notes: doi: 10.1016/j.jacbts.2020.07.004. , Word Count: 110

PMID: 32876647 PMCID: PMC7452234 DOI: 10.1016/j.jacbts.2020.07.004

In Ancient Chinese philosophy, yin and yang express a concept of dualism, underlying how seemingly opposite or contrary forces may actually be complementary, interconnected, and interdependent in the natural world. This concept perfectly applies to cardiovascular autonomic control, at least in physiological conditions. Sympathetic and parasympathetic efferent neurons tightly collaborate in a closed-loop system to constantly adjust cardiac output to body demands based on sensory feedback and feedforward control loops and complex integrative mechanisms. In pathological conditions, when the homeostatic capability of the system is overcome, maladaptive responses occur, leading, in the great majority of cases, to excessive sympathoexcitation coupled with reduced parasympathetic output.