Proceedings of the Heart-Brain Summit

Supplement Editor:
Marc S. Penn, MD, PhD

Contents

Introduction
Heart-brain medicine: Where we go from here and why
Marc S. Penn, MD, PhD, Cleveland Clinic, Cleveland, Ohio, and Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Opening remarks
The dream behind the summit
Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Keynote address
'Voodoo' death revisited: The modern lessons of neurocardiology
Martin A. Samuels, MD, DSc (hon), Brigham and Women's Hospital, Boston, Massachusetts

The broken heart syndrome
Ilan S. Wittstein, MD, Johns Hopkins University School of Medicine, Baltimore, Maryland

Brain imaging in cardiovascular disease: State of the art
Michael Phillips, MD, Cleveland Clinic, Cleveland, Ohio

Cortical control of the heart
Stephen Oppenheimer, MD, PhD, Sentient Medical Systems, Cockeysville, Maryland

Neurological mechanisms of chest pain and cardiac disease
Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

Hypertension in sleep apnea: The role of the sympathetic pathway
Diana L. Kunze, PhD; David Kline, PhD; and Angelina Ramirez-Navarro, PhD, MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio

Inflammation: Implications for understanding the heart-brain connection
Mehdi H. Shishehbor, DO; Carlos Alves, MD; and Vivek Rajagopal, MD, Cleveland Clinic, Cleveland, Ohio

The anti-ischemic effects of electrical neurostimulation in the heart
Jessica de Vries, MD, University of Groningen, The Netherlands; Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and Mike J.L.  DeJongste, MD, PhD, University of Groningen, The Netherlands

The little brain on the heart
J. Andrew Armour, MD, PhD, Hôpital du Sacré-Coeur and Université de Montréal, Montréal, Québec, Canada

Open heart surgery and cognitive decline
Mark F. Newman, MD, Duke University Medical Center, Durham, North Carolina

The heart and the brain within the broader context of wellness
Michael O’Donnell, PhD, MBA, MPH, Cleveland Clinic, Cleveland, Ohio

The heart-brain interaction during emotionally provoked myocardial ischemia: Implications of cortical hyperactivation in CAD and gender interactions
Robert Soufer, MD, Yale University, New Haven, Connecticut, and Matthew M. Burg, PhD, Yale University, New Haven, Connecticut, and Columbia University, New York, New York

Depression and heart disease
François Lespérance, MD, Montréal Heart Institute, and Nancy Frasure-Smith, PhD, McGill University and Montréal Heart Institute, Montréal, Québec, Canada

Sick at heart: The pathophysiology of negative emotions
Laura D. Kubzansky, PhD, MPH, Harvard School of Public Health, Boston, Massachusetts

Role of the brain in ventricular fibrillation and hypertension: From animal models to early human studies
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

New paradigms in heart-brain medicine: Nonlinear physiology, state-dependent proteomics
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

Subarachnoid hemorrhage: A model for heart-brain interactions
J. Javier Provencio, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac denervation in patients with Parkinson disease
David S. Goldstein, MD, PhD, National Institutes of Health, Bethesda, Maryland

Aging and the brain renin-angiotensin system: Insights from studies in transgenic rats
Debra I. Diz, PhD; Sherry O. Kasper, PhD; Atsushi Sakima, MD; and Carlos M. Ferrario, MD, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Contextual cardiology: What modern medicine can learn from ancient Hawaiian wisdom
Paul Pearsall, PhD, University of Hawaii at Manoa and Hawaii State Consortium for Integrative Medicine, Honolulu, Hawaii

Cardiocerebral resuscitation: The optimal approach to cardiac arrest
Gordon A. Ewy, MD, University of Arizona College of Medicine, Tucson, Arizona

Heart transplantation: A magnified model of heart-brain interactions
Mohamad H. Yamani, MD, and Randall C. Starling, MD, MPH, Cleveland Clinic, Cleveland, Ohio

Patent foramen ovale and migraine
Gian Paolo Anzola, MD, S. Orsola Hospital FBF, Brescia, Italy

Patent foramen ovale and stroke: To close or not to close?
Anthony J. Furlan, MD, Cleveland Clinic, Cleveland, Ohio

Sudden unexplained death in epilepsy: The role of the heart
Stephan U. Schuele, MD, Cleveland Clinic, Cleveland, Ohio, and Northwestern University, Chicago, Illinois; Peter Widdess-Walsh, MD, Adriana Bermeo, MD, and Hans O. Lüders, MD, PhD, Cleveland Clinic, Cleveland, Ohio

Hydrocephalus and the heart: Interactions of the first and third circulations
Mark Luciano, MD, PhD, and Stephen Dombrowski, PhD, Cleveland Clinic, Cleveland, Ohio

Cognitive impairment in chronic heart failure
Cathy A. Sila, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac events and brain injury: Ethical implications
Paul J. Ford, PhD, Cleveland Clinic, Cleveland, Ohio

Supplement Editor:
Marc S. Penn, MD, PhD

Contents

Introduction
Heart-brain medicine: Where we go from here and why
Marc S. Penn, MD, PhD, Cleveland Clinic, Cleveland, Ohio, and Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Opening remarks
The dream behind the summit
Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Keynote address
'Voodoo' death revisited: The modern lessons of neurocardiology
Martin A. Samuels, MD, DSc (hon), Brigham and Women's Hospital, Boston, Massachusetts

The broken heart syndrome
Ilan S. Wittstein, MD, Johns Hopkins University School of Medicine, Baltimore, Maryland

Brain imaging in cardiovascular disease: State of the art
Michael Phillips, MD, Cleveland Clinic, Cleveland, Ohio

Cortical control of the heart
Stephen Oppenheimer, MD, PhD, Sentient Medical Systems, Cockeysville, Maryland

Neurological mechanisms of chest pain and cardiac disease
Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

Hypertension in sleep apnea: The role of the sympathetic pathway
Diana L. Kunze, PhD; David Kline, PhD; and Angelina Ramirez-Navarro, PhD, MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio

Inflammation: Implications for understanding the heart-brain connection
Mehdi H. Shishehbor, DO; Carlos Alves, MD; and Vivek Rajagopal, MD, Cleveland Clinic, Cleveland, Ohio

The anti-ischemic effects of electrical neurostimulation in the heart
Jessica de Vries, MD, University of Groningen, The Netherlands; Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and Mike J.L.  DeJongste, MD, PhD, University of Groningen, The Netherlands

The little brain on the heart
J. Andrew Armour, MD, PhD, Hôpital du Sacré-Coeur and Université de Montréal, Montréal, Québec, Canada

Open heart surgery and cognitive decline
Mark F. Newman, MD, Duke University Medical Center, Durham, North Carolina

The heart and the brain within the broader context of wellness
Michael O’Donnell, PhD, MBA, MPH, Cleveland Clinic, Cleveland, Ohio

The heart-brain interaction during emotionally provoked myocardial ischemia: Implications of cortical hyperactivation in CAD and gender interactions
Robert Soufer, MD, Yale University, New Haven, Connecticut, and Matthew M. Burg, PhD, Yale University, New Haven, Connecticut, and Columbia University, New York, New York

Depression and heart disease
François Lespérance, MD, Montréal Heart Institute, and Nancy Frasure-Smith, PhD, McGill University and Montréal Heart Institute, Montréal, Québec, Canada

Sick at heart: The pathophysiology of negative emotions
Laura D. Kubzansky, PhD, MPH, Harvard School of Public Health, Boston, Massachusetts

Role of the brain in ventricular fibrillation and hypertension: From animal models to early human studies
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

New paradigms in heart-brain medicine: Nonlinear physiology, state-dependent proteomics
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

Subarachnoid hemorrhage: A model for heart-brain interactions
J. Javier Provencio, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac denervation in patients with Parkinson disease
David S. Goldstein, MD, PhD, National Institutes of Health, Bethesda, Maryland

Aging and the brain renin-angiotensin system: Insights from studies in transgenic rats
Debra I. Diz, PhD; Sherry O. Kasper, PhD; Atsushi Sakima, MD; and Carlos M. Ferrario, MD, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Contextual cardiology: What modern medicine can learn from ancient Hawaiian wisdom
Paul Pearsall, PhD, University of Hawaii at Manoa and Hawaii State Consortium for Integrative Medicine, Honolulu, Hawaii

Cardiocerebral resuscitation: The optimal approach to cardiac arrest
Gordon A. Ewy, MD, University of Arizona College of Medicine, Tucson, Arizona

Heart transplantation: A magnified model of heart-brain interactions
Mohamad H. Yamani, MD, and Randall C. Starling, MD, MPH, Cleveland Clinic, Cleveland, Ohio

Patent foramen ovale and migraine
Gian Paolo Anzola, MD, S. Orsola Hospital FBF, Brescia, Italy

Patent foramen ovale and stroke: To close or not to close?
Anthony J. Furlan, MD, Cleveland Clinic, Cleveland, Ohio

Sudden unexplained death in epilepsy: The role of the heart
Stephan U. Schuele, MD, Cleveland Clinic, Cleveland, Ohio, and Northwestern University, Chicago, Illinois; Peter Widdess-Walsh, MD, Adriana Bermeo, MD, and Hans O. Lüders, MD, PhD, Cleveland Clinic, Cleveland, Ohio

Hydrocephalus and the heart: Interactions of the first and third circulations
Mark Luciano, MD, PhD, and Stephen Dombrowski, PhD, Cleveland Clinic, Cleveland, Ohio

Cognitive impairment in chronic heart failure
Cathy A. Sila, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac events and brain injury: Ethical implications
Paul J. Ford, PhD, Cleveland Clinic, Cleveland, Ohio

Supplement Editor:
Marc S. Penn, MD, PhD

Contents

Introduction
Heart-brain medicine: Where we go from here and why
Marc S. Penn, MD, PhD, Cleveland Clinic, Cleveland, Ohio, and Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Opening remarks
The dream behind the summit
Earl E. Bakken, DSc (hon), Medtronic, Inc., Minneapolis, Minnesota, and North Hawaii Community Hospital, Kamuela, Hawaii

Keynote address
'Voodoo' death revisited: The modern lessons of neurocardiology
Martin A. Samuels, MD, DSc (hon), Brigham and Women's Hospital, Boston, Massachusetts

The broken heart syndrome
Ilan S. Wittstein, MD, Johns Hopkins University School of Medicine, Baltimore, Maryland

Brain imaging in cardiovascular disease: State of the art
Michael Phillips, MD, Cleveland Clinic, Cleveland, Ohio

Cortical control of the heart
Stephen Oppenheimer, MD, PhD, Sentient Medical Systems, Cockeysville, Maryland

Neurological mechanisms of chest pain and cardiac disease
Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

Hypertension in sleep apnea: The role of the sympathetic pathway
Diana L. Kunze, PhD; David Kline, PhD; and Angelina Ramirez-Navarro, PhD, MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio

Inflammation: Implications for understanding the heart-brain connection
Mehdi H. Shishehbor, DO; Carlos Alves, MD; and Vivek Rajagopal, MD, Cleveland Clinic, Cleveland, Ohio

The anti-ischemic effects of electrical neurostimulation in the heart
Jessica de Vries, MD, University of Groningen, The Netherlands; Robert D. Foreman, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and Mike J.L.  DeJongste, MD, PhD, University of Groningen, The Netherlands

The little brain on the heart
J. Andrew Armour, MD, PhD, Hôpital du Sacré-Coeur and Université de Montréal, Montréal, Québec, Canada

Open heart surgery and cognitive decline
Mark F. Newman, MD, Duke University Medical Center, Durham, North Carolina

The heart and the brain within the broader context of wellness
Michael O’Donnell, PhD, MBA, MPH, Cleveland Clinic, Cleveland, Ohio

The heart-brain interaction during emotionally provoked myocardial ischemia: Implications of cortical hyperactivation in CAD and gender interactions
Robert Soufer, MD, Yale University, New Haven, Connecticut, and Matthew M. Burg, PhD, Yale University, New Haven, Connecticut, and Columbia University, New York, New York

Depression and heart disease
François Lespérance, MD, Montréal Heart Institute, and Nancy Frasure-Smith, PhD, McGill University and Montréal Heart Institute, Montréal, Québec, Canada

Sick at heart: The pathophysiology of negative emotions
Laura D. Kubzansky, PhD, MPH, Harvard School of Public Health, Boston, Massachusetts

Role of the brain in ventricular fibrillation and hypertension: From animal models to early human studies
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

New paradigms in heart-brain medicine: Nonlinear physiology, state-dependent proteomics
James E. Skinner, PhD, Vicor Technologies, Inc., Boca Raton, Florida

Subarachnoid hemorrhage: A model for heart-brain interactions
J. Javier Provencio, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac denervation in patients with Parkinson disease
David S. Goldstein, MD, PhD, National Institutes of Health, Bethesda, Maryland

Aging and the brain renin-angiotensin system: Insights from studies in transgenic rats
Debra I. Diz, PhD; Sherry O. Kasper, PhD; Atsushi Sakima, MD; and Carlos M. Ferrario, MD, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Contextual cardiology: What modern medicine can learn from ancient Hawaiian wisdom
Paul Pearsall, PhD, University of Hawaii at Manoa and Hawaii State Consortium for Integrative Medicine, Honolulu, Hawaii

Cardiocerebral resuscitation: The optimal approach to cardiac arrest
Gordon A. Ewy, MD, University of Arizona College of Medicine, Tucson, Arizona

Heart transplantation: A magnified model of heart-brain interactions
Mohamad H. Yamani, MD, and Randall C. Starling, MD, MPH, Cleveland Clinic, Cleveland, Ohio

Patent foramen ovale and migraine
Gian Paolo Anzola, MD, S. Orsola Hospital FBF, Brescia, Italy

Patent foramen ovale and stroke: To close or not to close?
Anthony J. Furlan, MD, Cleveland Clinic, Cleveland, Ohio

Sudden unexplained death in epilepsy: The role of the heart
Stephan U. Schuele, MD, Cleveland Clinic, Cleveland, Ohio, and Northwestern University, Chicago, Illinois; Peter Widdess-Walsh, MD, Adriana Bermeo, MD, and Hans O. Lüders, MD, PhD, Cleveland Clinic, Cleveland, Ohio

Hydrocephalus and the heart: Interactions of the first and third circulations
Mark Luciano, MD, PhD, and Stephen Dombrowski, PhD, Cleveland Clinic, Cleveland, Ohio

Cognitive impairment in chronic heart failure
Cathy A. Sila, MD, Cleveland Clinic, Cleveland, Ohio

Cardiac events and brain injury: Ethical implications
Paul J. Ford, PhD, Cleveland Clinic, Cleveland, Ohio