Techniques are provided for controlling neurostimulation such as spinal cord stimulation (SCS) using a cardiac rhythm management device (CRMD). In various examples described herein, neurostimulation is delivered to a patient while regional cardiac performance of the heart of the patient is assessed by the CRMD. The delivery of further neurostimulation is adjusted or controlled based, at least in part, on the regional cardiac performance, preferably to enhance positive effects on the heart due to the neurostimulation or to mitigate any negative effects. Regional cardiac performance is assessed based on parameters derived from cardiogenic impedance signals detected along various vectors through the heart.