Neuroimmune and Neuroendocrine Mechanisms of the Brain-Heart Axis in Cardiovascular Diseases: A Review.

The brain-heart axis, a core bidirectional communication network linking the central nervous system and cardiovascular system, plays a pivotal role in the onset, progression, and prognosis of cardiovascular diseases when its regulatory homeostasis is disrupted. This review systematically examines the core regulatory pathways and molecular mechanisms of the brain-heart axis and highlights its pathological roles in major cardiovascular diseases, such as hypertension, coronary artery disease, heart failure, and arrhythmias. Particular emphasis is placed on recent advances in key pathways, including autonomic imbalance, hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, and dysregulation of neuroimmune and inflammatory responses. In parallel, this review explored translational pathways for clinical applications, including neurostimulation therapies, psychological intervention strategies, biomarker development, and personalized diagnostic and therapeutic protocols. By integrating mechanistic insights with translational perspectives, this article aims to provide a theoretical foundation for elucidating neurogenic mechanisms in cardiovascular disease and practical guidance for developing innovative precision-based diagnostic and therapeutic strategies.