{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:23:27Z","timestamp":1792790607144,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Current advances in management of the cardiac neuroaxis in different cardiovascular diseases require a deeper knowledge of cardiac neuroanatomy. The aim of the study was to increase knowledge of the human fetal extrinsic cardiac nervous system. We achieved this by systematizing the origin and formation of the cardiac nerves, branches, and ganglia and their sympathetic\/parasympathetic connections. Thirty human fetuses (60 sides) were subjected to detailed sub\u2010macroscopic dissection of the cervical and thoracic regions. Cardiac accessory ganglia lying on a cardiac nerve or in conjunction with two or more (up to four) nerves before entering the mediastinal cardiac plexus were observed in 13 sides. Except for the superior cardiac nerve, the sympathetic cardiac nerves were individually variable and inconstant. In contrast, the cardiac branches of the vagus nerve appeared grossly more constant and invariable, although the individual cardiac branches varied in number and position of origin. Each cervical cardiac nerve or cardiac branch of the vagus nerve could be singular or multiple (up to six) and originated from the sympathetic trunk or the vagus nerve by one, two, or three roots. Sympathetic nerves arose from the cervical\u2010thoracic ganglia or the interganglionic segment of the sympathetic trunk. Connections were found outside the cardiac plexus. Some cardiac nerves were connected to non\u2010cardiac nerves, while others were connected to each other. Common sympathetic\/parasympathetic cardiac nerve trunks were more frequent on right (70%) versus left sides (20%). The origin, frequency, and connections of the cardiac nerves and branches are highly variable in the fetus. Detailed knowledge of the normal neuroanatomy of the heart could be useful during cardiac neuromodulation procedures and in better understanding nervous pathologies of the heart.<\/jats:p>","DOI":"10.1002\/ca.24017","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T14:27:55Z","timestamp":1674570475000},"page":"550-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Innervation of the heart: Anatomical study with application to better understanding pathologies of the cardiac autonomics"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6803-8441","authenticated-orcid":false,"given":"Mail\u00e9n L.","family":"Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"},{"name":"Department of Cardiology, Sanatorio San Jos\u00e9  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5962-0237","authenticated-orcid":false,"given":"Sof\u00eda M.","family":"Pividori","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"},{"name":"Diagnostic Imaging Department, Hospital Brit\u00e1nico  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-5098","authenticated-orcid":false,"given":"Gregorio","family":"Fosser","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"},{"name":"Department of Orthopedic Surgery, Sanatorio G\u00fcemes  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8813-3240","authenticated-orcid":false,"given":"Agustina A.","family":"Pontecorvo","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7887-7986","authenticated-orcid":false,"given":"Verena B.","family":"Franco\u2010Riveros","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"},{"name":"Department of Pathology, Institute of Cardiovascular Physiopathology Buenos Aires University School of Medicine (INFICA)  Buenos Aires Argentina"},{"name":"National Scientific and Technical Research Council (CONICET). Institute of Biochemistry and Molecular Medicine (IBIMOL) Buenos Aires University School of Medicine  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1047","authenticated-orcid":false,"given":"Richard Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Anatomical Sciences St. George's University  St. George's Grenada"},{"name":"Department of Structural and Cellular Biology Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System  New Orleans Louisiana USA"},{"name":"Department of Neurology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-1214","authenticated-orcid":false,"given":"Andr\u00e9 P.","family":"Boezaart","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida USA"},{"name":"Lumina Health Pain Medicine Collaborative  Surrey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-1020","authenticated-orcid":false,"given":"Miguel A.","family":"Reina","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida USA"},{"name":"CEU\u2010San\u2010Pablo University School of Medicine  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6712-8103","authenticated-orcid":false,"given":"Bruno","family":"Buchholz","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Anatomy, First Unit, Cardiovascular Anatomy Lab Buenos Aires University  Buenos Aires Argentina"},{"name":"Department of Pathology, Institute of Cardiovascular Physiopathology Buenos Aires University School of Medicine (INFICA)  Buenos Aires Argentina"},{"name":"National Scientific and Technical Research Council (CONICET). 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