The search for a pathophysiological link between gender, cardiac endocrine function, body mass regulation and cardiac mortality: Proposal for a working hypothesis

Background: The discovery of cardiac natriuretic hormones determined a radical revision of the concept of heart function. It is now clear that the heart is not merely a pump but, through its endocrine function, exerts a nodal role in a complex information network. As a matter of fact the heart plays a key role in the regulation of circulation, salt-water homeostasis, and can exchange physiologically relevant information with other organs and systems. Content: Highlighting the most important recent literature observations, this review discusses the interrelationship between endocrine function of the heart and gonadal function. We have first considered the cross-talk between cardiac endocrine system and sex steroid hormones, examining the different actions of female sex steroid hormones and androgens on cardiac endocrine function, and then the action of cardiac natriuretic hormones on female and male gonadal function. Then, we have highlighted the clinical relevance of the relationships between cardiac endocrine function and sex steroid hormones in several clinical conditions associated with cardiovascular risk, focusing on mechanisms linking adipose tissue to natriuretic peptide and sex steroid hormone actions. Conclusion: The knowledge of the relation between cardiac endocrine function and other neurohormonal systems, including gonadal function, is crucial to explain the increased cardiovascular risk in some clinical conditions, such as obesity, arterial hypertension and metabolic syndrome. (C) 2009 Elsevier B.V. All rights reserved.