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H. E. Cingolani, N. G. Pérez, and M. C. Camilión de Hurtado are at the Centro de Investigaciones Cardiovasculares, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Argentina.
An autocrine/paracrine mechanism is triggered by stretching the myocardium. This mechanism involves release of angiotensin II, release/increased formation of endothelin, activation of the Na+/H+ exchanger, increase in intracellular Na+, and the increase in the Ca2+ transient that underlies the slow force response to stretch. The autocrine/paracrine mechanism could explain how changes in afterload alter cardiac contractility.
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