Coordination of autonomic outflows from intrathoracic neurons to cardiomyocytes depends to a large extent on sharing of inputs from higher centers along with interactions among and between various peripheral ganglia. Interactions within and between intrathoracic ganglia involve local circuit neurons (see earlier discussion). Activities generated by neurons in intrinsic cardiac ganglia demonstrate no consistent short-term relationship to neurons in extracardiac ganglia (19). However, the sharing of cardiopulmonary afferent information acting through both intrathoracic and brain stem/spinal cord feedback loops permits an overall coordination of ef fector control (Fig. 4) (19). Together, these nested feedback control systems allow for a redundancy in neural control of the heart, while at the same time maintaining an intrinsic flexibility to differentially modulate regional cardiac function (4).
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