Vagus nerve may hold the key to a younger and healthier heart

The secret to a healthier and "younger" heart lies in the vagus nerve. A recent study coordinated by the Sant'Anna School of Advanced Studies in Pisa and published in Science Translational Medicine has shown that preserving bilateral cardiac vagal innervation is an anti-aging factor. In particular, the right cardiac vagus nerve emerges as a true guardian of cardiomyocyte health, helping to preserve the longevity of the heart independently of heart rate.

The study is characterised by a strongly multidisciplinary approach, integrating experimental medicine and bioengineering applied to cardiovascular research. Specifically, the research was led by the Translational Critical Care Unit (TrancriLab) of the Interdisciplinary Research Center Health Science, under the responsibility of Professor Vincenzo Lionetti, and by the laboratory of the Biorobotics Institute led by Professor Silvestro Micera, which contributed to the development of the bioabsorbable nerve conduit used to facilitate vagal regeneration.

The experimental work was carried out in Pisa thanks to European FET (Future and Emerging Technologies) funding within the NeuHeart project and, in part, with the support of PNRR funds from the Tuscany Health Ecosystem. The study involved a broad network of Italian and international institutions of excellence, including the Scuola Normale Superiore, the University of Pisa, the Fondazione Toscana G. Monasterio, the Institute of Clinical Physiology of the CNR, the University of Udine, GVM Care & Research, Al-Farabi Kazakh National University, the Leibniz Institute on Ageing in Jena and the École Polytechnique Fédérale de Lausanne.

'When the integrity of the connection to the vagus nerve is lost, the heart ages more rapidly,' explains ProfessorLionetti.

'Even partial restoration of the connection between the right vagus nerve and the heart is sufficient to counteract the mechanisms of remodelling and preserve effective cardiac contractility,' adds Anar Dushpanova, cardiologist at TrancriLab.

The contribution of bioengineering was decisive. 'We have developed an implantable bioabsorbable nerve conduit designed to promote and guide the spontaneous regeneration of the thoracic vagus nerve at the cardiac level,' explains Eugenio Redolfi Riva, co-author of the neuroprosthesis patent at Biorobotics Institute

'Taken together, these results open new perspectives for cardiothoracic and transplant surgery, suggesting that restoring cardiac vagal innervation at the time of surgery may represent an innovative strategy for long-term heart protection, shifting the clinical paradigm from managing late complications associated with premature cardiac aging to their prevention,' concludes Professor Lionetti.