The whole heart is an endocrine gland

The relative contribution of atria and ventricles in the release of immunoreactive (IR-) atrial natriuretic factor (ANF) and in the eventual circulating levels of the peptide was evaluated in several situations. In situ, not only atrial but also ventricular cardiocytes contain IR-ANF although the amount present in ventricles is very low, particularly in the adult rat. In cardiomyopathic hamsters with heart failure, the amount of IR-ANF decreases constantly in the atria and increases in parallel in the ventricles so that the ratio of IR-ANF which is 114:1 in control animals becomes 3.9:1 in hamsters with severe heart failure. With the Langendorff preparation, the whole heart secretes much more IR-ANF than the isolated ventricles. From the latter, IR-ANF may originate from subendocardial cells of the conduction system and, more likely, from all ventricular cardiocytes where the peptide may be secreted by two pathways: one constitutive, the other regulated. These results are in agreement with clinical studies where circulating IR-ANF was measured in the same patients following catheterization of coronary sinus and great cardiac vein (draining the left ventricle). In this situation, it was found that while the levels of IR-ANF in the great cardiac vein are higher than in the general circulation, they are much lower than in the coronary sinus. All these results tend to indicate that IR-ANF is secreted by ventricular cardiocytes in relatively low amounts even in periods of intense stimulation.