Maintaining the heart’s connection to the vagus nerve may be a key defense against cardiac aging. Researchers showed that restoring this nerve pathway can protect heart cells and preserve heart strength long term.
Researchers have identified an unexpected factor that appears to help the heart stay healthier and younger for longer: the vagus nerve. A new study coordinated by the Sant’Anna School of Advanced Studies in Pisa and published today (December 24) in Science Translational Medicine found that maintaining vagal nerve connections to the heart on both sides acts as a powerful defense against cardiac aging. The findings point especially to the right cardiac vagus nerve, which plays a central role in protecting heart muscle cells and supporting long-term heart health, regardless of heart rate.
Combining Medicine and Bioengineering to Study Heart Aging
The research brought together expertise from multiple scientific fields, blending experimental medicine with advanced bioengineering focused on cardiovascular health. The study was led by the Translational Critical Care Unit (TrancriLab) of the Interdisciplinary Research Center Health Science, directed by Professor Vincenzo Lionetti. A second key contribution came from the Biorobotics Institute, led by Professor Silvestro Micera, which developed a bioabsorbable nerve conduit designed to support vagal nerve regrowth.
International Collaboration and Major Research Support
All experimental work was conducted in Pisa with funding from the European FET (Future and Emerging Technologies) program through the NeuHeart project, along with partial support from PNRR funds provided by the Tuscany Health Ecosystem. The effort included a wide network of Italian and international research institutions. Participants included 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.
Why the Vagus Nerve Matters for Heart Longevity
“When the integrity of the connection to the vagus nerve is lost, the heart ages more rapidly,” explains Professor Lionetti.
According to the research team, restoring this connection does not require complete regeneration to be effective. “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.
A Bioengineered Path to Nerve Regeneration
Bioengineering played a critical role in making these discoveries possible. “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.
New Possibilities for Heart and Transplant Surgery
“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.
Reference: “Reconnecting the vagus nerve to the heart through nerve conduit preserves cardiac function in a minipig model of right cardiac vagotomy” by Anar Dushpanova, Eugenio Redolfi-Riva, Valentina Casieri, Letizia Brogi, Chrysanthos Grigoratos, Fabio Bernini, Domiziana Terlizzi, Khatia Gabisonia, Ciro Zinno, Filippo Agnesi, Giulia Furini, Lisa Alibrandi, Aurora Paganelli, Valentina Sassu, Alessandro Carrozzo, Sabrina Marchetti, Silvia Burchielli, Jacopo Carpaneto, Micaela Sgorbini, Antonio Paolo Beltrami, Alessandro Cellerino, Giovanni Donato Aquaro, Silvestro Micera and Vincenzo Lionetti, 24 December 2025, Science Translational Medicine.
DOI: 10.1126/scitranslmed.aea4306
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