MODULATION OF MYOCARDIAL-CONTRACTION BY ENDOCARDIAL AND CORONARY VASCULAR ENDOTHELIUM

Endothelial cells in the heart, both endocardial endothelium and coronary vascular endothelium, influence myocardial contraction in isolated tissue and pump function in intact hearts by releasing diffusible agents that affect subjacent myocardium. Endocardial endothelium releases both nitric oxide (NO) and an unidentified ''contraction-prolonging substance'' (''endocardin'') that respectively decrease and increase the duration of twitch contraction, probably by altering myofibrillar calcium sensitivity. These agents modulate the duration of ejection and the timing of relaxation, but without significantly altering early systolic behavior. Coronary vascular endothelium also releases NO, with similar effects on contraction, and in addition probably releases several other agents. Current work is aimed at identifying all of the agents involved in these novel endothelial influences and studying their potential physiologic and pathophysiologic roles in cardiac contractile and other functions.