Evidence map›Paper›PMID 34603069›Full record

ReviewFrontiers in physiology2021

Asymmetry and Heterogeneity: Part and Parcel in Cardiac Autonomic Innervation and Function.

Tjitske E Zandstra, Robbert G E Notenboom, Jeroen Wink, Philippine Kiès, Hubert W Vliegen, Anastasia D Egorova, Martin J Schalij, Marco C De Ruiter, Monique R M Jongbloed

Open access · goldAbstract readReview
In one paragraph

Review in Frontiers in physiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 1 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.

  1. The relevance of the superior cervical ganglion for cardiac autonomic innervation in health and disease: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Determinants of carotid sinus hypersensitivity in patients with suspected reflex syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  6. Neurovascular interactions in the ageing heart.Nature reviews. Cardiology · 2026
    Review
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  9. Article
  10. Review
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  20. Electrophysiological comparison of left versus right stellate ganglia neurons.Journal of molecular and cellular cardiology plus · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Tjitske E ZandstraDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Robbert G E NotenboomDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands.
Jeroen WinkDepartment of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands.
Philippine KièsDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Hubert W VliegenDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Anastasia D EgorovaDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Martin J SchalijDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Marco C De RuiterDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands.
Monique R M JongbloedDepartment of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Leiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The cardiac autonomic nervous system (cANS) regulates cardiac adaptation to different demands. The heart is an asymmetrical organ, and in the selection of adequate treatment of cardiac diseases it may be relevant to take into account that the cANS also has sidedness as well as regional differences in anatomical, functional, and molecular characteristics. The left and right ventricles respond differently to adrenergic stimulation. Isoforms of nitric oxide synthase, which plays an important role in parasympathetic function, are also distributed asymmetrically across the heart. Treatment of cardiac disease heavily relies on affecting left-sided heart targets which are thought to apply to the right ventricle as well. Functional studies of the right ventricle have often been neglected. In addition, many principles have only been investigated in animals and not in humans. Anatomical and functional heterogeneity of the cANS in human tissue or subjects is highly valuable for understanding left- and right-sided cardiac pathology and for identifying novel treatment targets and modalities. Within this perspective, we aim to provide an overview and synthesis of anatomical and functional heterogeneity of the cANS in tissue or subjects, focusing on the human heart.

Indexed as

anatomical sidednessasymmetryautonomic nervous systemcardiac autonomic functionregional differencessympathetic cardiac nervesvagal cardiac branchesvagus nerve

Identifiers

PMID34603069
PMCPMC8481575
OpenAlexW3201083203

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.