Cardiac endocrine function is an essential component of the homeostatic regulation network: physiological and clinical implications.

Cardiac endocrine function is an essential component of the homeostatic regulation
network: physiological and clinical implications. Am J Physiol Heart Circ Physiol
290: H17-H29, 2006; doi:10.1152/ajpheart.00684.2005.--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.