Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation

• The ANS is a key regulator of cardiopulmonary health and disease and sleep/circadian pathophysiology. • Understanding cardiopulmonary sympathetic and parasympathetic nerve structure/function over disease time-course and cell type interactions is essential. • In vitro autonomic nervous system and experimental and computational integrative studies are necessary. • Clarifying sex-and race-specific cardiopulmonary and sleep/circadian influence on autonomic nerve function in response to neurotherapeutic interventions is critical to inform personalized strategies. 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.