by Irina Maria Vlad
The second day of the EAN Congress 2026 closed with a session that was both scientifically rich and clinically important. The joint EAN/ESC session on Brain & Heart Interaction for Cognitive Function and Longevity offered a timely reminder that the brain and heart cannot be understood as separate organs. Despite the late hour, the room remained attentive, reflecting the growing recognition that this field is central to the future of neurology, cardiology, prevention, rehabilitation, and health across the lifespan.
Held under the chairmanship of Matthias Endres, Director of the Department of Neurology with Experimental Neurology at Charité – Universitätsmedizin Berlin, the session emphasised that brain-heart communication is not a one-way process. Rather, it is a dynamic, bidirectional system in which the brain influences cardiac function and the heart, in turn, shapes brain health, cognition, resilience, and clinical outcomes.
In his lecture, ‘Individualized Cognitive Risk in Cardiovascular Disease’ Riccardo Proietti, cardiologist and Senior Clinical Lecturer at the University of Liverpool, delivered a forward-looking presentation on digital monitoring and systems biology in heart-brain medicine. He suggested that recovery and decline are not driven by one organ alone, but by complex communication across multiple systems. He also pointed toward a systems biology perspective, moving beyond traditional models based mainly on shared risk factors and organ failure, and considering how multi-organ communication may shape different pathways to disease. Digital biomarkers of heart-brain crosstalk could eventually help reflect molecular pathways such as BDNF and orexin signalling, although proving and validating these connections remains an important challenge for future research.
Daniela Carnevale, professor at Sapienza University of Rome, offered a translational overview of the brain-heart axis by widening the discussion toward neuroimmune and autonomic pathways. In her presentation she illustrated for example, how the brain continuously integrates signals from within the body, through interoception, and from the external environment, through exteroception, and how these inputs may shape responses. Drawing on her experimental work, she highlighted the spleen as an important interface in this communication, connected to the brain through autonomic circuits involving the vagus nerve, celiac ganglion, and sympathetic splenic innervation. Rather than presenting the heart and brain as isolated organs, her approach showed them as part of a broader brain-heart-spleen network, in which neuronal, immune, and vascular mechanisms interact.
Endres closed the session with a clinically powerful update on stroke-heart syndrome, underscoring why the brain-heart axis has immediate relevance for everyday neurological care. He outlined the high risk of cardiac events after stroke and reviewed the definition, manifestations, frequency, time course, and prognosis of stroke-related cardiac complications. A central focus was troponin elevation after acute ischemic stroke, illustrated through important clinical studies. Endres carefully distinguished cardiac injuries, emphasising the importance of the absolute initial level of high-sensitivity cardiac troponin as a predictor for myocardial infarction after stroke. His presentation made clear that stroke-heart syndrome is not only a mechanistic concept, but also a pressing diagnostic and therapeutic challenge: how to identify, monitor, and treat stroke patients with very high troponin before cardiac complications worsen outcomes.
Overall, the EAN/ESC session made clear that the brain-heart axis is no longer a niche topic. It is central to understanding cognitive function, vascular health, recovery after neurological injury, and healthy longevity. By bringing together translational science, cardiology, and neurology, the session offered a timely reminder: protecting the brain means protecting the heart, and protecting the heart may be one of the most powerful strategies for preserving the brain.
Impression for social media: The ESC/EAN heart-brain sessions expand our horizons beyond neurology, making us look at the heart and brain together, in their complexity.
