Endocrinology Of The Heart

Endocrinology of the Heart in Health and Disease: Integrated, Cellular, and Molecular Endocrinology of the Heart covers the traditional concepts of cardio-endocrinology, the role of the various hormone systems, both in health and disease, therapeutic implications, and other recent advances in the various fields represented. The book explores how cardiac hormones are changed in various cardiac pathologies and the recent success that has been uncovered in their therapeutic use. Additional focus is placed on how the heart responds both physiologically and pathophysiologically to a plethora of circulating hormones, reinforcing the importance of the heart as a target of numerous endocrine systems, such as the brain, renal, and adipose. Significant advances have come from basic, clinical, and translational research from a multiplicity of investigators with diverse backgrounds. The book features over 200 photomicrographs, diagrams of molecular relationships, and tables that complement and support the text. It is aimed at a wide audience, including graduate students and post-doctoral fellows in a wide array of biomedical departments and PhD programs (e.g. Pathology, Physiology, Genetics, Pharmacology, Molecular Biology, and Cell Biology) related to the endocrine and cardiovascular sciences curricula, as well as medical residents in pathology, laboratory medicine, internal medicine, and cardiology. Develops the concept of the heart as both an endocrine organ and an endocrine target, exploring the endocrine function of the heart in both health and disease Explains how the levels of several cardiac hormones are changed in various cardiac pathologies and how some hormones can be used therapeutically Offers a single resource on cardio-endocrine disease which collates and curates the wide range of advances being made in the areas of molecular biology, biochemistry, physiology, and pathology

Starting with the morphology of the myoendocrine cell and the biochemistry and physiology of cardiac hor mones, the book describes pathophysiological findings and discuss their clinical relevance in congestive heart failure, arterial hypertension, renal insufficiency, and cirrhosis of the liver. Furthermore, evidence is presented for the role of the heart as a target organ for various endocrine factors such as thyroid hormones, catecholamines, renin-angiotensin, growth hormones and endogenous opioids.

In 1956, Bruno Kisch (90) discovered a special form of myocyte in the guinea pig heart atrium which contained peculiar, dense inclusions, but it was not before the early 1980s that cardiac hormones were isolated and characterized independently and almost simultaneously by several working groups. In 1964 Jamieson and Palade (84) were the first to postulate the secretory nature of the atrial myocytes and their specific granules. In 1976, Marie et al. (103) revealed the relation of the granular index of these atrial cells with the water- electrolyte balance of the body fluid. The biological effects of purified atrial extracts, i. e. , the diuretic and vasorelaxant effects, were detected in the early 1980s, (26,35,38,56). Now, a series of polypeptides, of the same family, and all derived from a homologous precursor in the different species are know to exert the diuretic and vasorelaxant effects. This development of the discovery of a peptide hormone is unparalleled in the sense that it was mostly morphologists who contributed to the final characterization of these cardiac hormones. Thus, it was a great honor for us to be given the opportunity on the occasion of the 8th European Anatomical Congress to organize a special satellite symposium on the rapidly growing field of research in cardiac endocrinology. The symposium "Functional Endocrinology of the Endocrine Heart" was planned as an interdisciplinary meeting to enable anatomists to follow recent advances in cardiac endocrinology.

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.

Growth Hormone and the Heart endeavors to bring together knowledge that has been accumulated in the area of GH and the heart, from basic to clinical studies, by research groups working on this topic throughout the world. Lessons from different experimental models and from several human diseases (acromegaly, adult GH deficiency, heart failure) suggest to endocrinologists and cardiologists that GH may not only have a role in the physiology and pathophysiology of heart function, but that GH itself may have a place in the treatment of primary heart diseases (such as dilated cardiomyopathy) or of cardiac complications of hypopituitarism. Growth Hormone and the Heart will be a useful update of the research produced in the field of cardiovascular endocrinology. The Editors also hope that this book will serve as the primary step in the recognition of the wide physiological and clinical significance of GH and heart interactions.

Most endocrine diseases, if not treated or controlled, have cardiovascular manifestations. Both GH deficiency and GH excess impair cardiovascular functions, e.g. in patients with acromegaly, who have a shortened life expectancy and increased mortality mostly due to cardiovascular complications in uncontrolled disease. Moreover, Cushing’s syndrome and diabetes are well known for metabolic and cardiovascular manifestations, as well as hypo- and hyperthyroidism. Both adipose tissue and the heart have been increasingly recognized as organs with partially endocrine functions, which produce adipokines and brain natriuretic peptide, respectively, and influence a number of cardiovascular parameters. Primary aldosteronism as a cause for secondary hypertension is still a great challenge to detect and diagnose properly; however, new important discoveries have been made regarding the genetics of this probably underestimated cause of hypertension. Written by distinguished researchers in their respective fields, this book will give both researchers and clinicians an excellent update on all these topics, as well as provide insight into the use of hormones as treatment tools in more controversial areas.

In recent years, several scientific papers have highlighted the role of the thyroid system in cardioprotection, and several clinical studies – including multicenter studies – have identified the role of thyroid hormones (TH) in the development and progression of cardiovascular disease, making an update of TH and heart relationship both necessary and timely. This second edition of Thyroid and Heart failure provides a careful and updated review of the experimental, clinical and epidemiological results in the field of TH and heart failure, with a particular focus on the translational - bench to bedside - significance of the obtained results. It discusses topics such as the molecular, structural, functional, cellular and histological cardiac changes; the reversibility of these changes with TH replacement therapy; the systemic effects – kidney, hormonal pathways systems, brain, muscle, etc – of altered TH metabolism in HF, as well as the clinical and prognostic implications. The section devoted to the potential therapeutic treatments has been expanded. Thanks to its translational approach to this highly complex subject, the book will be of interest to a broad readership, including cardiologists, endocrinologists and internists.

Endocrinology of Cardiovascular Function is a fitting inauguration to the Endocrine Update Series. The aim of these publications is to provide the clinician with cutting edge, yet succinct, access to the latest advances in endocrinology. Historically, our understanding of hormonal disturbances was restricted to the classical secretory glands and their targets. As Endocrinology of Cardiovascular Function so aptly indicates, endocrinology is no longer constrained by our early physiologic understanding of glandular disorder. Endocrinology of Cardiovascular Function has set the standard of excellence for the future volumes in this series. Shlomo Melmed, M.D. Series Editor, Endocrine Update Growth factors such as IGF-1 play important roles in cardiovascular cell hypertrophy and the response to acute vascular injury. From another perspective, traditional endocrine hormones, such as estrogen, have been found to participate in preventing the development of atherosclerosis in women, acting through novel mechanisms on target vascular cells. Other `endocrine' hormones, such as PTHRP and adrenomedullin, also modulate cardiovascular and renovascular dynamic states, suggesting new roles for these peptides as vasodilators. This multi-authored text is dedicated to highlighting emerging and important new information regarding the endocrinology of the cardiovascular system. Ellis R. Levin, M.D.