The Heart as a Target of Vasopressin and Other Cardiovascular Peptides in Health and Cardiovascular Diseases

Abstract

The automatism of cardiac pacemaker cells, which is tuned, is regulated by the autonomic nervous system (ANS) and multiple endocrine and paracrine factors, including cardiovascular peptides. The cardiovascular peptides (CPs) form a group of essential paracrine factors affecting the function of the heart and vessels. They may also be produced in other organs and penetrate to the heart via systemic circulation. The present review draws attention to the role of vasopressin (AVP) and some other cardiovascular peptides (angiotensins, oxytocin, cytokines) in the regulation of the cardiovascular system in health and cardiovascular diseases, especially in post-infarct heart failure, hypertension and cerebrovascular strokes. Vasopressin is synthesized mostly by the neuroendocrine cells of the hypothalamus. There is also evidence that it may be produced in the heart and lungs. The secretion of AVP and other CPs is markedly influenced by changes in blood volume and pressure, as well as by other disturbances, frequently occurring in cardiovascular diseases (hypoxia, pain, stress, inflammation). Myocardial infarction, hypertension and cardiovascular shock are associated with an increased secretion of AVP and altered responsiveness of the cardiovascular system to its action. The majority of experimental studies show that the administration of vasopressin during ventricular fibrillation and cardiac arrest improves resuscitation, however, the clinical studies do not present consisting results. Vasopressin cooperates with the autonomic nervous system (ANS), angiotensins, oxytocin and cytokines in the regulation of the cardiovascular system and its interaction with these regulators is altered during heart failure and hypertension. It is likely that the differences in interactions of AVP with ANS and other CPs have a significant impact on the responsiveness of the cardiovascular system to vasopressin in specific cardiovascular disorders.

Keywords: angiotensin; cytokines; heart failure; hypertension; hypoxia; inflammation; oxytocin; resuscitation; stress; vasopressin.

Figure 1

Components of the vasopressin system involved in the regulation of blood flow in the brain, heart, vessels, kidney, lungs and digestive system. AVP—arginine vasopressin; SNS—sympathetic nervous system; V1aR—vasopressin V1a receptors; V1bR—vasopressin V1b receptors; V2R—vasopressin V2 receptors.

Figure 2

Interaction of vasopressin, angiotensins, oxytocin and cytokines with the autonomic nervous system in the regulation of cardiovascular parameters. Stress, anxiety, pain, hypoxia and inflammation enhance the release of vasopressin, oxytocin, angiotensins and cytokines in the brain, heart and vessels, and these peptides regulate the function of the heart and vessels through central and intracardiac effects. Ang II—angiotensin II; Ang (1–7)—angiotensin-(1–7); AT1R—AT1 receptors, AVP—arginine vasopressin; IL-1β—interleukin 1-β; OTR—oxytocin receptors; OXY—oxytocin; TGF-β—transforming growth factor β; TNF-α—tumor necrosis factor α; V1aR—vasopressin V1a receptors. → sequence of events, ↑- increased activation, ↓ - decreased activation.