Hormones and the Heart in Health and Disease (Contemporary Endocrinology Book 21)

The maintenance of arterial blood pressure and the distribution of blood flow to the various organs of the body depends on the control of the pumping action of the heart and of the resistance of the vascular beds in the individual organs in accordance with their metabolic needs. These controls are achieved through the integrated actions of circulat­ ing hormones, humoral factors that are synthesized and released in the heart and blood vessels, and the autonomic nervous system. The heart, however, is not only the target for the direct and indirect actions of a number of hormones and humoral factors, it is also an endocrine organ in the traditional sense, synthesizing and secreting into the circulation chemical factors that act at distant sites. In this treatise, Hormones and the Heart in Health and Disease, we interpret "endocrinology" broadly and consider traditional hormones as well as autocoids that are secreted by the heart or that act on it. In this overview, the relevant chapters are indicated in parentheses. The discovery of atrial natriuretic peptide (ANP; atrial natriuretic factor, ANF) in the 1980s indicated that the heart does indeed function as an endocrine organ in the classic sense. ANP (Chapter I) is synthesized in the heart and secreted into the circulation for actions on the kidney, where it is a potent natriuretic agent, and on the vasculature, where it causes vasodilation. ANP can also affect myocardial contractility.

Leonard Share and a panel of distinguished clinicians and investigators critically review what is known about the effects of endogenous hormones and other chemical agents that act upon and/or are secreted by the heart. Among the humoral factors reviewed in depth are ANP, adrenomedullin, urocortin, vasopressin, and insulin, as well as the autocoids, endothelin, nitric oxide, estrogen, and the eicosanoids. Also illuminated are the roles played by the renin-angiotensin-aldosterone system, by the autonomic nervous system, and by the kallikrein-kinin system in the functioning of the heart. Offers physiologists, pharmacologists, and academic cardiologists powerful insights into the hormonal factors that modulate cardiac performance in health and disease. Contributing substantially to our understanding of the physiology and pathophysiology of the heart, this important book is certain to serve as the new standard reference for all those involved in basic and clinical cardiovascular studies as well as in developing today's novel cardiotherapeutics.

Irwin Klein

Anatomists and physiologists have described the classic endocrine organs as those that release hormones that act at distant sites. The importance of the many individual hormones to regulate a multitude of homeostatic processes is well known. It is well accepted that the heart and vascular systems are important end-organs for hormone action and many disease states involving changes in hormone secretion are recognized for their effects on this system. In this book, the editor has enlisted the aid of 29 contributors to address fourteen different areas in which hormones can potentially alter cardiovascular physiology. The editor states that the purpose is to systematically review a variety of specific hormones as they affect both normal and pathologic states. The attempt to further our understanding of the regulation of cardiac function is clearly laudable and in each chapter the contributors make a significant contribution to the basic understanding of how a variety of molecules including nitric oxide, the eicosanoids, and the recently identified adrenomedullin can act on the heart and systemic vasculature. While the title suggests a clinical bent, it appears that this book is primarily directed to basic scientists. The linchpin chapter deals with naturetic peptides and the heart. The reader is guided through the molecular biology of the structure and processing of the various cardiac derived naturetic peptides, and a discussion of the transcriptional regulation is provided. This forms the basis for understanding the regulation of the naturetic peptides in the pathologic states of cardiac hypertrophy, heart failure, and myocardial infarction. Unfortunately the vast majority ofthis work is directed at the cell, organ, and intact animal and those observations which have been made in the human disease states or the clinical implications of that work are not fully explored. Each of the contributors is an acknowledged expert in the field and the chapters are carefully prepared and contain sufficient citations to make these contributions of reference value. The chapter on estrogen and the heart stands out from the others in that it is primarily clinically oriented and quickly departs from molecular biology and the effects of estrogen to a very useful clinical discussion. This includes the clinical findings of estrogen on vasomotor tone, echocardiography and other measures of myocardial contractility, and on changes in lipid levels in patients receiving estrogen replacement and contrasting that to estrogen deficiency. The comprehensive nature of the book is further supported by the review of renin-angiotensin, endothelin, and insulin. The emphasis in most of these chapters is on the more basic issues such as glucose transport in the heart rather than incorporation of the recent important clinical data dealing with pathologic bases for diabetic cardiomyopathy (if one exists) or on the alterations in insulin sensitivity, lipid metabolism, blood pressure, and atherosclerosis, which form an important metabolic syndrome. I find this book to be useful as a reference source and also for its completeness. I am personally disappointed to find that in any discussion of the effects of hormones on the heart that one of the most recognized and well established areas, that of thyroid hormone (and its effects on the heart and cardiovascular system), is not discussed. Nor is the recent and potentially clinically important data of the role of growth hormone and cardiac function reviewed. The field of cardiovascular endocrinology is moving forward and this book does make an important contribution, however, the clinician may need to look elsewhere to fully understand the significance of this evolving field.

Front Matter....Pages i-x Natriuretic Peptides and the Heart....Pages 1-20 Adrenomedullin and the Heart....Pages 21-38 Cardiac and Vascular Actions of Urocortin....Pages 39-52 The Renin-Angiotensin System and the Heart....Pages 53-67 Adrenocortical Hormones and the Heart....Pages 69-79 Catecholamines and the Heart....Pages 81-101 Vasopressin and the Heart....Pages 103-113 Insulin and the Heart....Pages 115-135 Kinins in the Heart....Pages 137-158 Endothelin and the Heart....Pages 159-174 Nitric Oxide and the Heart....Pages 175-193 Contribution of Eicosanoids in the Heart....Pages 195-218 Estrogen and the Heart....Pages 219-233 Androgen and Estrogen Effects on Plasma Lipids in Men....Pages 235-251 Back Matter....Pages 253-258 In 1981 DeBold et al. (l) made a seminal observation that opened an entirely new field of investigation in cardiovascular research.