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Title	Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation: A Report From the National Heart, Lung, and Blood Institute and the National Institutes of Health Office of the Director Workshop.
Author	Mehra, Reena; Tjurmina, Olga A; Ajijola, Olujimi A; Arora, Rishi; Bolser, Donald C; Chapleau, Mark W; Chen, Peng-Sheng; Clancy, Colleen E; Delisle, Brian P; Gold, Michael R; Goldberger, Jeffrey J; Goldstein, David S; Habecker, Beth A; Handoko, M Louis; Harvey, Robert; Hummel, James P; Hund, Thomas; Meyer, Christian; Redline, Susan; Ripplinger, Crystal M; Simon, Marc A; Somers, Virend K; Stavrakis, Stavros; Taylor-Clark, Thomas; Undem, Bradley Joel; Verrier, Richard L; Zucker, Irving H; Sopko, George; Shivkumar, Kalyanam
Journal	JACC Basic Transl Sci	Publication Year/Month	2022-Mar
PMID	35411324	PMCID	PMC8993767
Affiliation + expend	1.Cleveland Clinic, Cleveland, Ohio, USA.
	2.Case Western Reserve University, Cleveland, Ohio, USA.
	3.National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
	4.David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
	5.Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA.
	6.University of Florida, Gainesville, Florida, USA.
	7.University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
	8.Cedars-Sinai Medical Center, Los Angeles, California, USA.
	9.University of California Davis, Davis, California, USA.
	10.University of Kentucky, Lexington, Kentucky, USA.
	11.Medical University of South Carolina, Charleston, South Carolina, USA.
	12.University of Miami Miller School of Medicine, Miami, Florida, USA.
	13.National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA.
	14.Oregon Health and Science University School of Medicine, Portland, Oregon, USA.
	15.Amsterdam University Medical Centers, Amsterdam, the Netherlands.
	16.University of Nevada Reno, Reno, Nevada, USA.
	17.Yale University School of Medicine, New Haven, Connecticut, USA.
	18.Ohio State University, Columbus, Ohio, USA.
	19.University of Dusseldorf, Germany, Dusseldorf, Germany.
	20.Harvard Medical School, Boston, Massachusetts, USA.
	21.University of California Davis School of Medicine, Davis, California, USA.
	22.University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
	23.University of California-San Francisco, San Francisco, California, USA.
	24.Mayo Clinic, Rochester, Minnesota, USA.
	25.University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
	26.University of South Florida, Tampa, Florida, USA.
	27.Johns Hopkins University, Baltimore, Maryland, USA.
	28.Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
	29.University of Nebraska Medical Center, Omaha, Nebraska, USA.

Abstract

This virtual workshop was convened by the National Heart, Lung, and Blood Institute, in partnership with the Office of Strategic Coordination of the Office of the National Institutes of Health Director, and held September 2 to 3, 2020. The intent was to assemble a multidisciplinary group of experts in basic, translational, and clinical research in neuroscience and cardiopulmonary disorders to identify knowledge gaps, guide future research efforts, and foster multidisciplinary collaborations pertaining to autonomic neural mechanisms of cardiopulmonary regulation. The group critically evaluated the current state of knowledge of the roles that the autonomic nervous system plays in regulation of cardiopulmonary function in health and in pathophysiology of arrhythmias, heart failure, sleep and circadian dysfunction, and breathing disorders. Opportunities to leverage the Common Fund\'s SPARC (Stimulating Peripheral Activity to Relieve Conditions) program were characterized as related to nonpharmacologic neuromodulation and device-based therapies. Common themes discussed include knowledge gaps, research priorities, and approaches to develop novel predictive markers of autonomic dysfunction. Approaches to precisely target neural pathophysiological mechanisms to herald new therapies for arrhythmias, heart failure, sleep and circadian rhythm physiology, and breathing disorders were also detailed.

Keywords

ACE, angiotensin-converting enzyme

AD, autonomic dysregulation

AF, atrial fibrillation

ANS, autonomic nervous system

Ach, acetylcholine

CNS, central nervous system

COPD, chronic obstructive pulmonary disease

CSA, central sleep apnea

CVD, cardiovascular disease

ECG, electrocardiogram

EV, extracellular vesicle