Humoral control of the CVS

9 important questions on Humoral control of the CVS

What are the main hormones imporant for cardiovascular control?

- circulating sympathetic hormones: o.a. epinephrin
- hormones produced by the renin-angiotensin aldosteron system (RAAS): angiotensin II, aldosteron
- atrial natriuretic peptide (ANP) 
- hormones produced by the hypothalamic-pituitary axis: vasopressin (ADH = antidiuretic hormone)

What are the characteristics of epinephrine?

Circulating sympathetic neurotransmitter produced by the adrenal medulla (bijnier) under sympathetic stimulation

When does the kidney produces aldosteron? And how?

When the kidneys are stimulated by sympathetic stimulation, hypotension or less sodium delivery. Renin converts angiotensinogen into AI, which is then converted to AII by ACE (released particularly from the lungs). AII can influence the adrenal cortex to produce aldosterone. AII has also some other effects: affects thirst center in the brain, affects renal sodium and fluid retention, affects vasoconstriction and on the long term it causes cardiac and vascular hypertrophy.
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What is the pathway for production and working of atrial natriuretic peptide (ANP)?

ANP is released by the atrial due to atrial distension, sympathetic stimulation, angiotensin II and endothelin. ANP is degraded by NEP (neutral endopeptase). NEP can be blocked pharmacologically, thus elevating ANP levels.
ANP acts on the kidneys and decreases the renin release, which in turn lowers angiotensin II and aldosterone. Furthermore, it causes natriuresis and diuresis, which decreases the blood volume (more filtered out, thus more fluid leaves the body). It also decreases the SVR (systemic vascular resistance) and CVP (central venous pressure).

What are the actions of vasopressin? And how is it produced?

Produced by the pituitary (hypophysis) due to angiotensin II, hyperosmolarity, decreased atrial receptor firing or sympathetic stimulation. Vasopressin causes vasoconstriction -> increases arterial pressure, and renal fluid reabsorption -> increase the blood volume

What are the myogenic factors?

Mechanism counteracts pressure induced changes in vascular diameter

What are the endothelial factors?

Endothelial cells produce a lot of substances, among which NO, EDHF, ET-1 and PGI2. The endothelial cells are stimulated to release those substances by circulating hormones, paracrine hormones, shearing forces and hypoxia.

Which diseases are associated with dysfunctional endothelium / diminished bioavailability of NO?

Hypertension
Coronary vasospasm
Obesity
Dyslipidemias (hypercholesterolemia, hypertriglyceridemia)
Diabetes (I and II)
Heart failure

When is the heart perfused?

During diastole. The left coronary blood flow is almost stopped during systole, due to high contracting forces on the left venticle. At high heart rates the diastolic period abbreviated: potential problems for patients with coronary artery stenoses.

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