Spatiotemporal dynamics of brain-heart communication: from asymmetric neural regulation to systemic neuro-immune-endocrine interactions

Traditional cardiovascular pathophysiology often relies on heart-centric models, yet the maintenance of neurocardiac homeostasis fundamentally depends on higher-order central regulation. While the bidirectional brain-heart axis is widely recognized, the spatiotemporal principles governing its network dynamics remain incompletely understood. This review presents an integrative theoretical framework to conceptualize brain-heart communication not merely as a linear reflex, but as a hierarchical, multidimensional process. We highlight the critical role of asymmetric neural regulation - where lateralized central control dictates efferent autonomic outflow - and map how this central asymmetry progressively cascades into a systemic neuro-immune-endocrine interactive network. By adopting this multiscale perspective, we delineate the mechanistic pathways through which psychological stress acts as an upstream driver to precipitate cardiovascular vulnerabilities, such as arrhythmias and heart failure. Furthermore, we discuss the translational potential of this framework, emphasizing how spatiotemporal features can be leveraged to develop dynamic biomarkers and guide precision neuromodulation therapies, ultimately providing new avenues for restoring neurocardiac homeostasis.