Abstract 

The heart and brain form a complex and bidirectional communication system known as the cardio-cognitive axis, which plays a crucial role in maintaining physiological homeostasis and regulating adaptive behaviors. This intricate relationship involves neural, hormonal, and vascular mechanisms that affect cognitive function, emotional regulation, and overall health. Recent advances in neuroscience and cardiology have revealed the profound impact of dysregulation in this axis on cognitive decline, mood disorders, and cardiovascular diseases. This review explores the physiological, neurobiological, and pathological aspects of the heart-brain connection, focusing on the interconnections between the autonomic nervous system (ANS), neurohormonal pathways, and inflammatory processes. We also discuss the clinical implications of this axis in conditions such as heart failure, stroke, neurodegenerative diseases, and cognitive decline. Additionally, emerging therapeutic targets are highlighted, with a view to advancing clinical practice and research in the field.