Summary
In 1986, Brutsaert et al. observed that the endocardial endothelium (EE) directly controls performance of the myocardium. From this observation, the existence of an endocardium-mediated intracavitary autoregulation of cardiac performance has been postulated. Recent discoveries on morphology and function of the endocardium have substantiated this hypothesis. Morphologically, phenotypic expression of several receptors, tight and gap junctions, adhesion molecules, intercellular clefts, and a specific organization of the cytoskeleton distinguishes the EE from other endothelial subtypes and emphasizes a structural and functional specialization. Functionally, the EE imparts a twitch-prolonging and positive inotropic effect on cardiac muscle, apparently by enhancing the responsiveness of myocardial contractile proteins to Ca2+. EE-mediated control of myocardial performance resembles length/volume-mediated control and interacts with neurohumoral-mediated control. EE cells respond to physical and humoral stimuli with release of several substances that have important inotropic actions on the myocardium. Specific electrophysiological properties determine the intracellular Ca2+ increase in response to external stimuli and modulate the release of these substances. An asymmetrical distribution of ion channels between the luminal and abluminal membrane of the EE suggests a specific transendothelial transport of ions over the endocardium. Accordingly, the endocardium is highly specialized for communication with and regulation of the myocardium. It will be interesting to evaluate endocardium-mediated control of cardiac performance in pathophysiological conditions.
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De Keulenaer, G.W. et al. (1997). Endocardial—Myocardial Interaction. In: Maruyama, Y., Hori, M., Janicki, J.S. (eds) Cardiac-Vascular Remodeling and Functional Interaction. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67041-4_13
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DOI: https://doi.org/10.1007/978-4-431-67041-4_13
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