Cardiovascular Neuromodulatory Therapy

Dear Colleagues,

The role of the autonomic nervous system in chronotropic, inotropic, dromotropic, and lusitropic aspects of cardiac function is known. Thus, it is unsurprising that autonomic dysfunction participates in the development and progression of major cardiovascular diseases, including hypertension, myocardial infarction, heart failure, and sudden cardiac death. In fact, evidence has shown that cardiovascular dysfunction associated with myocardial infarction and heart failure, for example, is characterized by sympathetic hyperexcitation and withdrawal of the central parasympathetic tonus, leading to the study and use of therapies that reduce sympathetic activity to the heart, in the form of beta-blockade of adrenergic receptors or inhibition of the renin–angiotensin–aldosterone axis. Despite the universal use of these drugs, there is a remaining cardiovascular risk in treating patients and disease progression occurs, creating the need for new therapeutic approaches. In this context, interest in neuromodulation as a new therapeutic approach, with pharmacological therapies or through direct stimulation of arterial baroreceptors, the vagus nerve, and even renal denervation, has shown positive results in managing hypertension, heart failure and refractory ventricular arrhythmias. Furthermore, recently, new drugs, such as SGLT2 inhibitors and others, have also been proven to be effective in their neurohormonal action. Although these initial studies are promising, it is essential to advance our knowledge of the cardiovascular autonomic effects of both traditional and new pharmacological therapies, considering their possible pleiotropic effects or the remaining risk, for the development and implementation of precise neuromodulatory therapies. Therefore, this Special Issue is focused on the neuromodulatory effects of drugs and therapies in cardiovascular disease.

Dr. Cláudia Costa Irigoyen
Prof. Dr. Kátia De Angelis
Guest Editors

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• cardiovascular autonomic regulation
• cardiovascular disease
• drug therapy
• baroreflex
• heart rate variability
• inflammation
• oxidative stress