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Cardiac endocrine function is an essential component of the homeostatic regulation network: physiological and
Aldo Clerico1, Fabio A Recchia, Claudio Passino
1Laboratory of Cardiovascular Endocrinology and Cell Biology, CNR Institute of Clinical Physiology, Via Trieste 41, 56126 Pisa, Italy. clerico@ifc.cnr.it
Insights
The heart is more than a pump; it
Area of Science:
- Cardiology
- Endocrinology
- Physiology
Background:
- The heart's function has been traditionally viewed as solely mechanical (a pump).
- Recent discoveries reveal the heart's significant endocrine role.
- This endocrine function is integral to the body's complex regulatory networks.
Purpose of the Study:
- To review the interplay between the heart's endocrine and contractile functions.
- To propose that cardiac endocrine function is vital for maintaining homeostasis.
- To explore the role of cardiac endocrine dysfunction in cardiovascular diseases, particularly heart failure.
Main Methods:
- Literature review of existing studies on cardiac hormones and cardiovascular physiology.
- Analysis of research linking cardiac endocrine function to systemic homeostasis.
- Examination of studies on the pathophysiology of heart failure and natriuretic peptide resistance.
Main Results:
- The heart acts as a multifunctional organ, interacting within integrated bodily systems.
- Cardiac endocrine function is proposed as essential for fluid, electrolyte, and hemodynamic balance.
- Alterations in cardiac endocrine function offer insights into cardiovascular disease pathophysiology, including heart failure.
Conclusions:
- Understanding cardiac endocrine function is crucial for interpreting natriuretic hormone levels.
- The heart's endocrine role is pivotal in maintaining overall body homeostasis.
- Further research into cardiac endocrine function and its interactions with neurohormonal systems is essential.
Abstract:
The discovery of cardiac natriuretic hormones required a profound revision of the concept of heart function. The heart should no longer be considered only as a pump but rather as a multifunctional and interactive organ that is part of a complex network and active component of the integrated systems of the body. In this review, we first consider the cross-talk between endocrine and contractile function of the heart. Then, based on the existing literature, we propose the hypothesis that cardiac endocrine function is an essential component of the integrated systems of the body and thus plays a pivotal role in fluid, electrolyte, and hemodynamic homeostasis. We highlight those studies indicating how alterations in cardiac endocrine function can better explain the pathophysiology of cardiovascular diseases and, in particular of heart failure, in which several target organs develop a resistance to the biological action of cardiac natriuretic peptides. Finally, we emphasize the concept that a complete knowledge of the cardiac endocrine function and of its relation with other neurohormonal regulatory systems of the body is crucial to correctly interpret changes in circulating natriuretic hormones, especially the brain natriuretic peptide.
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